肝切除治疗肝胆管结石(附644例报告)

分析肝切除治疗肝胆管结石的疗效。方法报告１９７５年至１９９９年１１月６４４例肝内胆管结石病人采用肝切除治疗的术式，并发症及随访情况，结果本组治疗方式中合并的肝切除率为５２％；６４４例中６２．９％经历过１－５次手术，其中２０．５％，合并不同类型的胆肠吻合。肝切除术式：左外叶切除３７８例（５８．７％）；左半肝切除１３２例（２０．５％）；右半肝切除３１例（４．８％）；多段切除６６例（１０．３％）；肝方叶

Hepatic lobectomy and segmental resection of liver for intrahepatic bile duct stones: a report of 644 cases

Objective To analyse curative effects of lobectomy and segmental resection of liver for intrahepatic bile duct stones. Methods Six hundred and forty four patients suffering from intrahepatic bile duct stones and having undergone lobectomy and segmental resection from 1975 to Nov. of 1999 were analysed. Results In these 644 patients 62.9% underwent 1 to 5 operations, including different types of cholangioduodenostomy (20.5%). The types of hepatectomy, included left lateral hepatectomy (378 cases, 58.7%), left hemihepatectomy (132 cases, 20.5%), right hemihepatectomy (31 cases, 4.8%), multiple segmental resections (66 cases, 10.3%), and different hepatectomies combined with quadrate lobectomy (37 cases, 5.7%). Postoperative complicatons occurred in 18.9% cases, including transient biliary fistula, hemobilia, and subdiaphragmatic and resectional surface infections. Ten patients (1.5%) died. Eighty six percent of the patients were followed up for an average of 15.5 years and excellent result of 88% was achieved. Conclusions The authors emphasize that hepatic lobectomy and segmental resection are the core of treatment and selection of operative method depends on clinico pathologic types of the disease.