肝叶切除治疗肝内胆管结石256例的体会

目的 探讨肝叶切除治疗肝内胆管结石的疗效. 方法 回顾性总结1996-12～2006-12在我科行肝叶切除治疗肝内胆管结石256例的经验与体会. 结果 本组无手术死亡,术后并发症有胆漏12例（4.69%）,膈下感染7例（2.73%）,腹腔脓肿5例（1.95%）和肝功能衰竭2例（0.78%）.本组获随访者229例,随访时间4个月～10年,平均7年3个月.93.01%术后症状消失,工作生活正常;5.68%偶有轻度胆管炎发作;1.31%仍反复发作严重胆道感染. 结论 肝叶切除术是治疗肝内胆管结石最有效的手段之一.

Clinical experience of hepatic lobectomy for the treatment of 256 patients with hepatolithiasis

Objective To explore the method and effect of hepatectomy for the treatment of the patients with hepatolithiasis. Methods Retrospective summary was made on 256 patients with hepatolithiasis undergone different types of hepatic lobectomy from December 1996 to December 2006. Results None of patients died in operation. The postoperative complications included biliary fistulas （12 patients, 4. 69% ）, subphrenic infection （7 patients, 2. 73% ）, peritoneal abscesses （5 patients, 1.95% ） and liver failure （2 patients, 0. 78% ）. Long-term follow-up was performed in 229 patients. The follow-up time ranged from 4 months to 10 years with an average of 7 years and 3 months. The results showed that 93.01% of patients were without symptom and could work and live normally; 5.68% of patients had occasional mild attacks of cholangitis; 1.31% of patients had severe cholangitis requiring further surgical intervention. Conclusion Hepatic lobectomy is one of the most effective treatments for hepatolithiasis.