肝叶切除配合胆道镜取石治疗肝内胆管结石的体会

目的探讨肝内胆管结石的治疗方法。方法对20例行肝叶或肝段切除,或肝实质切开取石病人资料进行回顾性分析。结果 20例中施行肝左外叶切除或左外叶并部分左内叶切除共17例,行肝实质切开取石3例。全组病人无死亡。术后发生胆汁瘘1例,肝下间隙感染1例,并发症发生率10.0%(2/20)。残石率80.0%(16/20)。全组病例手术6周以后常规经T管窦道行纤维胆道镜检查或取石,取石1次或多次。全组病例随访1～10年,随访期间无结石复发。结论选择肝叶切除治疗肝内胆管结石应设计好切肝范围,术后配合纤维胆道镜取石可以取得较好的临床效果。

Treatment experience of hepatic lobectomy and choledochoscopy for hepatolithiasis

Objective To explore the treatment methods of hepatolithiasis.Methods The efficiency and patterns of hepatic lobectomy,segmentectomy or hepatectomy were retrospectively analyzed on 20 cases of hepatolithiasis.Results Among the 20 cases of hepatolithiasis,left lateral liver and/or partial left medial liver of 17 patients was resected,of 3 patients the liver was slit and then the stones were removed.There were no deaths.Biliary fistulas and infection in subhepatic space in one case each.The rate of complicati...