肝胆管结石并肝萎缩肥大复合征的处理

目的 总结手术治疗肝胆管结石并肝萎缩—肥大复合征的经验。方法 对37例肝胆管结石并肝萎缩—肥大复合征患者进行手术并随访。结果 术后残石率为21．6％(8／37)，经胆道镜取石，最后降为16．2％(6／37)。随访37例，时间7个月至5年10个月，平均3年5个月，其中2年6个月以上者25例，在随访中，有4例出现不同程度的胆管炎，效果优良者占88％。结论 肝胆管的充分显露和切开是手术成功的关键；术式选择取决于结石、胆管狭窄的位置及数量、肝脏的病理改变及术中患者状况。

Management of intrahepatic stones complicated with atrophy-hypertrophy complex

Objective To summarize the experience in surgical treatment of intrahepatic bile stones complicated with atrophy hypertrophy complex (IBS AHC). Methods Thirty seven cases of IBS AHC were surgically treated and followed up. Results The postoperative residual rate was 21 6% (8/37). After fibrocholedochoscopy, the residual rate was reduced to 16 2% (6/37). All the patients were followed up for an average of 3 years and 5 months and 25 of them were followed up for over 2 years and 6 months. The follow up study showed that cholangitis occurred in 4 patients. The rate of good outcome was as high as 88%. Conclusions Complete exposure and incision of the intrahepatic and biliary tracts are very important for operational success. Surgical approaches should be determined by the position and quantity of stones, obstruction, pathological changes of the liver and situation of the operation.