肝切除治疗肝胆管结石

目的 探讨肝切除治疗肝胆管结石的疗效。方法 回顾性分析了1980年2月至1999年2月128例肝胆管结石采用肝切除治疗的术式和治疗效果。结果 肝切除治疗肝胆管结石占整个手术治疗病人的41．29％。其中左外叶切除78例，占60．94％；左半肝切除18例，占14．06％；肝方叶切除7例，占5．47％；右半肝及右肝段切除25例，占19．53％；附加胆肠吻合术50例，占39．06％。手术并发症18例，占14．06％。术后1个月内死亡2例，占1．56％。106例(82．8l％)获2～20年随访，平均随访12．5年，优良率90．56％。结论 肝切除治疗肝胆管结石是最有效的治疗手段，其中早期的肝切除治疗效果最佳。

Hepatic lobectomy or segmentectomy for the treatment of intrahepatic lithiasis

Objective To investigate the therapeutic effect of hepatic lobectomy or segmentecto-my on intrahepatic lithiasis. Methods The clinical data of 128 patients with intrahepatic lithiasis treated by hepatic lobectomy or segmentectomy in our hospital from February 1980 to February 1999 were retrospectively analyzed. Results These 128 patients accounted for 41. 29% of those receiving operation in that period of time. Amongst the 128 patients, 78 (60. 94%) were treated with left lateral lobectomy, 18 (14.06%) with left hemihepatectomy, 7 (5.47%) with quadrate lobectomy and 25 (19. 35%) with right hemihepatectomy or segmentectomy. In addition, 50 of them (39. 06%) also received chole-enterostomy. Postoperative complications were found in 18 patients (14.06%) and 2 (1. 56%) died. The follow-up study conducted in 106 patients for an average of 12. 5 yr showed that excellent results were achieved in 90. 56% of the patients. Conclusions Regular partial hepatectomy is the most effective treatment for intrahepatic lithiasis and its earlier use results in better outcome.