肝硬化门脉高压症合并胆囊结石的治疗

目的总结肝硬化门脉高压症合并胆囊结石的外科治疗经验。方法回顾性分析17例肝硬化门脉高压症合并单纯胆囊结石的临床诊治资料。结果10例行断流术并结合治疗胆囊结石组(3例同期手术),5例分期手术,2例并中西利胆排石)与7例单纯断流术组近期肝功能改善率及食道胃底静脉曲张消除率比较无明显差异(P>0.05),远期肝功能改善率明显优于单纯断流术组,分别为71.4%和14.3%(P<0.05),再出血率小于单纯断流术组(P<0.05)。结论肝硬化门脉高压症合并胆囊结石行断流术结合治疗胆囊结石的预后较单纯断流术好,并且只要加强围手术期的处理,同期手术是安全可行的。

TREATMENT OF PORTAL HYPERTENSION IN LIVER CIRRHOSIS ASSOCIATED WITH CHOLELITHIASIS

Objective To assess the effect of surgical treatment of liver cirrhosis associated with cholelithiasis.Methods 17 cases of liver cirrhosis associated with cholelithiasis were retrospectively analyzed.Result 17 cases of liver cirrhosis associated with cholelithiasis (among those,3 cases treated simultaneously.5 cases separately and 2 cases added with traditional Chinese medicine were treated of portal hypertension only.We found that there is no significant difference in the recent improvement of liver function as well as removal of vein dilatation in esophagus and stomach in two groups(P>0.05).However,the long-term effect on liver function is obviously different(71.4% and 14.3% respectly,P<0.05).The rate of re-hemorrhage in former group decreased dramatically compared with the latter(P<0.05).Conclusion Treated both of portal hypertension and cholelithiasis is proved a more effective method than of portal hypertension only.And it is a safe therapy,provided the post-surgical treatments being strengthened.