摘要
目的探讨左半肝切除术治疗肝胆管结石中尾状叶保护的应用价值。方法回顾性分析2013年1月至2016年9月泰州市人民医院肝胆外科采用左半肝切除尾状叶保护技术治疗肝胆管结石37例患者的临床资料。结果所有病例均顺利完成手术,平均手术时间(186.4±35.6)min,平均出血(227.2±26.4)m L,平均住院时间(13.4±3.2)d。术后出现胆瘘1例(2.7%),肺部感染1例(2.7%),无腹腔感染、腹腔出血、肝功能衰竭、切口感染。术后结石残留1例(2.7%),位于胆总管下端,于术后2个月经T管窦道胆道镜取出。所有病例均获得随访,随访时间为2~45个月,仅2例(5.4%)复发,疗效优良。结论左半肝切除术中,采用恰当的入肝血流控制、肝离断路径及左肝管残端处理方法,可保护尾状叶功能,减少术后并发症发生,增加了手术的安全性,术后近、远期效果良好。
Objective To explore the application value of caudate lobe preservation in the left hepatectomy for hepatolithiasis.Methods The clinical data of 37 patients with hepatolithiasis treated by left hepatectomy from Jan.2013 to Sep.2016 were analyzed retrospectively.Results All patients underwent surgeries successfully.The average operative time was（186.4±35.6） min,the average hemorrhage volume was（227.2±26.4） mL,and the average hospitalization length was（13.4±3.2） d.The postoperative biliary fistula occurred in 1 patient（2.7%）,the pulmonary infection occurred in 1 patient（2.7%）.No complication occurred such as abdominal infection,abdominal hemorrhage,liver failure or wound infection.Postoperative residual stone occurred in 1 patient（2.7%）,which located in the lower end of the common bile duct and was removed under choledochoscopy via T-tube sinus tract in 2 months.All patients were followed-up for 2 to 45 months,and only 2 patients（5.4%） had recurrence.Conclusion During the left hepatectomy,the caudate lobe function can be protected by proper methods for hepatic inflow control,liver partition pathway and left hepatic duct stump treatment,which significantly reduces the incidence of postoperative complications and increase the surgery safety.The postoperative recent and long-term curative effects are good.
作者
陈曦
叶青
袁寅
杨兴业
周红兵
刘庆宏
钱海鑫
CHEN Xi;YE Qing;YUAN Yin;YANG Xing-ye;ZHOU Hong-bin;LIU Qing-hong;QIAN Hai-xin(Department of General Surgery,the First Hospital of Soochow University,Suzhou,Jiangsu 215006,China;Department of Hepatobiliary Surgery,Taizhou People＇s Hospital,Taizhou,Jiangsu 225300,China)
出处
《肝胆胰外科杂志》
CAS
2018年第4期271-273,共3页
Journal of Hepatopancreatobiliary Surgery
