规则性肝段切除联合胆管镜取石治疗肝内胆管结石131例术式及疗效分析

目的探讨规则性肝段(叶)切除联合胆管镜取石治疗肝内胆管结石术式及远期疗效。方法回顾性分析1998年1月至2009年12月广安市人民医院采用规则性肝段(叶)切除联合胆管镜取石治疗131例肝内胆管结石患者的术后并发症,结石残留、复发及胆管感染等情况。结果131例患者术后恢复良好,无术后死亡。随访病例112例,随访期10个月至8年,其中症状消失93例(83.0%),术后结石残留8例(7.1%),复发7例(6.3%),胆管反复感染伴疼痛5例(4.5%)。结论规则性肝段(叶)切除联合胆管镜取石术安全有效,可降低残石、结石复发率,远期疗效较好,是目前治疗肝内胆管结石的可靠治疗方法之一。

Clinical Study of 131 Cases with Hepatolithiasis Treated with Regular Liver Lobes Resection Combined with Choledochoscopic Stone-removing

Objective To investigate the methods and long-term follow-up results of treating hepatolithiasis with regular liver lobes resection combined with choledochoscopic stone-removing.Methods The recovery,residual stone,recurrence and infection of biliary tract of 131 cases of regular liver lobes resection combined with choledochoscopic stone-removing in Guang′an People Hospital from January 1998 to December 2009 were summarized.Results 131 cases recovered to good health and there were no operative deaths.In the follow-up of 112 cases for 10 months to 8 years,93 cases(83.0%)were cured,8 cases(7.1%)had residual stones,7 cases(6.3%)had recurrence,and 5 cases(4.5%)had the infection and ache of biliary tract repeatedly.Conclusion Regular liver lobes resection combined with choledochoscopic stone-removing is safe and effective,which can reduce the stone residue rate and recurrence rate,presenting good long-term effect,thus is one of the most reliable ways to treat hepatolithiasis.