肝胆管结石并左肝肥大右肝萎缩的分型与手术治疗

目的总结肝胆管结石并左肝肥大、右肝萎缩的分型和手术治疗经验。方法对320例肝胆管结石并左肝肥大、右肝萎缩患者在分型基础上实施手术,其中Ⅰ型98例,Ⅱ型128例,Ⅲ型13例,Ⅳ型55例,Ⅴ型25例,Ⅵ型1例。结果无术后死亡病例,主要并发症为腹水13例,切口脂肪液化18例,应激性溃疡8例,均经保守治疗获得治愈。269例获随访,平均3.15年（3月～13年）,优124例,良104例,差41例,优良率为84.8%。结论根据肝胆管结石并左肝肥大、右肝萎缩的分型,采取相应恰当的手术治疗,可获较好效果。

Classification and Surgical Treatment of Hepatolithiasis Accompany with Left Hepatic Hypertrophy and Right Hepatic Atrophy

Objective To evaluate the classification and surgical treatment experiences of intrahepatic bile stones accompany with left hepatic hypertrophy and right hepatic atrophy.Methods 320 cases of intrahepatic bile stones accompany with left hepatic hypertrophy and right hepatic atrophy had done operations in the base of yping.There were 98 cases of TypeⅠ,128 of TypeⅡ,13 of type Ⅲ,55 of type Ⅳ,25 of Ⅴ and 1 of Type Ⅵ.Results There was no mortality after operation.Major complications included ascites(13 cases),fat liquefaction incision(18 cases),stress ulcer(8 cases).All cases were cured by conservative treatment.In the 269 cases who were followed up for 3 months to 13 years,with 3.15 years in average,there were 124 cases of good clinical effect,104 of fine and 41 cases of worse.The total good and fine effect rate was 84.8%.Conclusion The adoption of the appropriate surgical treatment according to the classification of the left hepatic hypertrophy and right hepatic atrophy is the guarantee for the good operative results.