保留胆囊对肝内外胆管结石术后复发的影响

目的通过对接受对肝内、外胆管结石患者术中保留胆囊,观察保留胆囊后胆管结石远期复发情况并进行评价。方法共59例纳入研究,其中有37例胆总管结石合并或不合并胆囊结石病人行保留胆囊(保胆术)的胆总管切开取石术;22例肝内胆管结石合并或不合并胆囊结石,行保留胆囊的取石手术(包括肝部分切除、胆总管切开胆道镜取石),远期随访观察两组病例复发率。结果保留胆囊的胆总管结石3年复发率为2.7%;保留胆囊的肝内胆管结石3年复发率4.54%,与文献相比复发率低,但保留胆囊的肝外胆管结石术后结石复发率与文献报道的差异没有统计意义。结论保留胆囊没有增加肝内、外胆管结石的复发,胆囊功能的保留有助于胆道系统的完整性,这可能有利于减少肝内、外胆管结石术后的复发。

Effect of gallbladder retention on postoperative recurrence of intrahepatic and extrahepatic cholelithiasis

［Abstract］ Objective To observe the preservation of gallbladder in patients with intrahepatic andextrahepatic cholelithiasis by comparing with the traditional method of cholecystectomy. Methods Thirty? seven patients with choledocholithiasis or with cholecystolithiasis were treated with choledocholithiasis and22 patients with intrahepatic cholelithiasis or cholelithiasis were treated with choledocholithotomy. Cholecystolithotomy （including partial hepatectomy）. Results The recurrence rate of intrahepatic choledocholithiasis was 4.54% and the recurrence rate of cholecystic choledocholithiasis was 2.7%，which was significantly lower than that of the literature. Conclusion The strategy of preserving the gallbladder in intrahepatic and extrahepatic calculi surgery does not increase the recurrence of intrahepatic and extrahepatic bile duct stones. The preservation of gallbladder function contributes to the integrity of the biliary system and may reduce the chance of recurrence of intrahepatic and extrabiliary calculi.