肝实质切开取石术联合胆道镜治疗肝内胆管结石的疗效分析

目的探究肝实质切开取石术联合胆道镜治疗肝内胆管结石的临床效果。方法对2006年1月至2010年12月间行肝实质切开取石联合胆道镜治疗肝内胆管结石45例患者的临床资料进行回顾性分析。结果结石残留率8.9%（4/45）,术后发生胆汁漏4例,膈下感染5例,结石复发9例,复发率为20.0%。结论胆道镜联合肝实质切开取石术治疗肝内胆管结石结石取净率高,操作简单,创伤小,术后并发症少,适用于年老、心肺等重要器官功能不全患者、危重患者急诊手术或不具备肝叶、段切除手术条件的情况。

Study on therapeutic effect of open liver parenchyma cholelithotomy combined with choledochoscopy in patients with intrahepatic bile duct stones

Objective To explore the clinical effect of open liver parenchyma cholelithotomy combined with choledochoscopy in treatment of intrahepatic biliary calculi.Methods Clinical data of 45 patients performed open liver parenchyma cholelithotomy combined with choledochoscopy during January 2006 to December 2010 were retrospectively analyzed.Results The rate of residual calculi was 8.9 %（4 / 45 cases）,postoperative biliary leakage was occurred in 4 cases,subphrenic infection was seen in 5 cases,and recurrence of stones had been seen in 9 cases.Conclusion The net rate of choledochoscopy combined with open liver parenchyma cholelithotomy for surgical treatment of intrahepatic bile duct stones is high with simple in procedure,less trauma,few postoperative complications,and it is suitable for aged patients with cardiopulmonary dysfunction and critically ill patients with emergency operation especially without operational condition for lobar or segmental resection.