球囊扩张法辅助治疗复杂性肝胆管结石并狭窄

目的 探讨球囊扩张法辅助治疗复杂性肝胆管结石并狭窄的经验,以提高诊治水平.方法 对我院2001年1月～ 2010年1月收治的21例复杂肝胆管结石的临床资料进行回顾性分析.结果 本组21例均采用手术切开狭窄部,术中视情况切除部分肝脏,经胆道镜取石后行肝管空肠吻合,并于吻合口内放置扩张球囊,均顺利完成手术.术后定期行球囊渐进性扩张,随访观察1～5年,治愈14例,好转6例,出现并发症1例.结论辅助球囊扩张法是一种治疗复杂肝胆管结石并狭窄较为安全可靠的方法.

Preliminary Study of Treatment of Hepatolithus Complicated by Biliary Stricture after Iatrogenic Injury

Objective To summarize the treatment experiences in patients with complicated intrahepatic stones complicated by biliary stricture in order to improve treatment level.Methods A retrospective analysis was performed on clinical data of 21 patients with complicated intrahepatic stones during January 2001 and January 2010.Results The discission in the stenotic parts of 21 patients were preferentially carried out and followed by partial hepatectomy in the other patients.Subsequently the hepatojejunostomy was then performed after the stones were removed ander choledochoscope.In the precedure of hepatojejunostomy,the balloons were placed in the anastomotic stoma and were progressively dilated regularly after the operation.All the operations were successful.After the follow-up of 1-5 years,14 patients were cured,6 showed improvements,and only 1 had complications.Conclusion The treatment of progressive balloon dilatation,with hepatectomy and hepatic portal plasty has good safety and efficiency in the treatment of complicated intrahepatic stones accompanied with biliary stricture.