肝部分切除术治疗肝内胆管结石38例

目的：观察肝部切除治疗肝内胆管结石的疗效。方法：C地38例肝内胆管结石病人的进行了肝叶或肝段切除,其中部分病人同时行胆总管空肠吻合术,根据详细的影像学资料（CT,PCT等）。了解肝内胆管结石的分布,确定手术方案。结果：33例随诊病中,疗效：优24例,良5例,差4例,有结石残留9例,残石率为27．3％,因残石引起肝脓肿反复胆管炎发作需再手术5例,再手术率为15．2％,术后并发症：38例病人术后发生胆漏2例,膈下感染1例,肝断面出血1例,结率：肝内胆管结石只要严格掌握手术指征,行肝部切除效果满意,产吩病人可以根治。

Partial hepatectomy for hepatolithiasis: an analysis of 38 cases

Objective: To observe the curative effect of partial hepatolithiasis on hepatectomy. Methods: Hepatic lobes or segments were resected in 38 patients with hepatolithiasis and some of them were concurrently operated on with choledochojejunostomy. According to the detailed imaging data (CT, PCT, etc.), the distribution of hepatolith were learnt .Results:The results of the 33 patients followed up were as follows: 24 were excellent, 5 were good and 4 were poor. Nine patients (27 3%) had residual stones, 5 (15 2%) were reoperated on for the hepatic abscess and recurrence of cholangitis induced by the residual stones. Complications were found in 4 of the 38 patients, including 2 biliary fistulae, 1 subphrenic infection and 1 bleeding in the liver cut. Conclusion: If the operative indication of hepatolithiasis is strictly followed, the outcome of hepatectomy will be satisfactory and some of the patients can be radically healed. [