118例复杂性肝胆管结石的临床手术疗效比较

目的:比较单纯取石术与综合性手术治疗复杂性肝胆管结石的临床疗效。方法 :回顾性分析2010年7月—2012年6月山东大学附属省立医院诊治的118例复杂性肝胆管结石患者的临床资料。按照手术方法不同分为单纯取石组(A组,33例)和综合治疗组(B组,85例)。结果:B组患者治疗有效率为94.9%(74/78),A组治疗有效率为82.8%(24/29),两组比较差异有统计学意义(P0.05)。结论:对于复杂性肝胆管结石,个体化、综合性手术能有效去除病灶,复发率低,有助于提高患者长期生活质量。

Clinical diagnosis and treatment research of complicated biliary calculi

Objective： To sum up clinical diagnosis and treatment experience of complicated bitiary calculi（CBC） in order to test the different clinical efficacy. Methods. A series of 118 patients with CBC treated in Provincial Hospital Affiliated to Shandong University between jul. 2010 and jun. 2012 were retrospectively reviewed and analyzed. They were divided into two groups and under-went two different therapeutic methods. Group A ： only remove the stone （n=33）,Group B： comprehensive treatments （n=85）. Results： Patients in group B were treated by removing the stone combined with various kinds of treatment ,the effective rate of treatment was 94.9%, the group A was treated with removing the stone by was 82.8%. Postoperative complications occurred operative during the treatment, the effective rate in 23 cases, including ascites and pleural effusion in 19 cases（6 cases in group A）, live abscess 3 cases（1 case in group A）, biliary and abdominal abscess 1 case （in group B）, whom all recovered from symptomatic treatment. The mean follow up was 26 months （range 18 to 41 months）, and no evidence of cancerous was found during the follow up period. Conclusion： CBC is a disease with high recurrence rate and stone residual rate. Individual and comprehensive operation is the first and effective choice of treatment plan with lower recurrence, and can improve life quality of patients with long-term.