不同手术方法治疗肝胆管结石的临床疗效

目的比较不同手术方法治疗肝胆管结石的临床疗效。方法将我院收治的105例肝胆管结石患者根据病情及治疗方式随机分为对照组42例和观察组63例，对照组采取常规开腹肝部分切除术并T管引流术，观察组采取胆总管切开取石并胆肠吻合内引流术。比较两组患者手术时间、术中出血量、术后下床时间、术后残石率、复发率及并发症发生率。结果观察组患者手术时间、术中出血量及术后下床时间均显著小于对照组（P〈0．01）；观察组患者残石率、复发率及并发症发生率均显著低于对照组（1．59％VS14．29％，0％VS9．52％，4．76％VS19．05％），差异有显著性（／9〈0．05）。结论胆总管切开取石及胆肠吻合内引流术相较常规开腹肝部分切除术并T管引流术创伤小、疗效好、预后快、术后残石率及复发率低、并发症少，值得临床推广应用。

Clinical effect of different surgical treatment methods for hepatic calculus

Objective Toobservethechnicaleffectofdifferentsurgicahherapyonhepaticcalculus. Methods 105 patients with hepatic calculus were randomly divided into 2 groups. The 42 patients in control group were treated with surgical therapy of curative liver resection plus bihary drainage while the 63 patients in observation group were treated with surgical therapy of lithotomy common bile duct plus biliary drainage. We recorded the operating time, amount of bleeding, recovery time, relapse rate, the rate of postoperative residual stone and the incidence of postoper- ative complications. Results The operating time, amount of bleeding, recovery time, the rate of postoperative residual stone（ 1.59% ）, relapse rate（0%）, and the incidence of postoperative complications（4.76%） in the observation group were all significantly lower than those in the control group （P〈0.05）. Conclusion The clinical effect of lithotomy common bile duct pins biliary drainage is better in treatment of hepatic calculus.