早期肝胆管结石的肝切除治疗

目的探讨早期肝胆管结石肝切除的治疗效果。方法回顾性分析了1980—2002年20例早期肝胆管结石肝切除的治疗效果。结果早期肝胆管结石肝切除治疗占同期肝切除治疗的14.29%(20/140)。其中左外叶切除8例,左外叶上段切除2例,左外叶下段切除2例,左半肝切除2例,右后叶切除3例,右后叶下段切除2例,右前叶部分切除1例。附加胆总管切开12例,预防性行胆肠Roux-Y吻合术1例。术后并发症3例,其中胆总管残余结石1例,切口感染和肝断面积液各1例。无手术死亡。全部病例获得3～14年随访,优良率达95%。结论早期肝胆管结石的肝切除治疗效果甚佳。

Treatment of early intrahepatic cholelithiasis with hepatectomy

Objective To investigate the therapeutic efficacy of hepatic lobectomy or segmentec- tomy for early intrahepatic cholelithiasis.Methods The clinical data of 20 patients with intrahepatic cholelithiasis receiving hepatic lobectomy or segmentectomy from 1980 to 2002 in our hospital were retrospectively analyzed.Results Accounting for 14.29% of the total hepatectomy-treated intrahepat- ic cholelithiasis cases in that period of time,these 20 cases underwent different types of regular partial hepatectomy including the left anterior lobectomy in 8,left lobectomy in 2,left superior lobectomy in 2,left inferior lobectomy in 2,right posterior lobectomy in 3,right posterior inferior lobectomy in 2 and right frontier partial lobectomy in 1.Choledochotomy was combined in 12 cases and preventive chole-enterostomy in 1.Postoperative complications occurred in 3 cases and no patient died.All the 20 cases were followed up for 3-14 years and the excellent rate was as high as 95%.Conclusions Hepa- tectomy can achieve good results in treatment of early intrahepatic cholelithiasis.