以肝段切除为主的联合手术治疗肝胆管结石并狭窄

目的探讨以肝段切除为主的联合手术治疗肝胆管结石并狭窄的临床疗效。方法肝胆管结石并狭窄患者66例,均行肝段切除加胆总管探查、T管引流术,行Roux-en-Y胆肠吻合术17例,肝门部胆管、肝断面胆管-空肠双吻合术9例,肝门部胆管扩张成形术4例。结果手术均获得成功,术后发生胆管残石5例(7.6%),切口感染3例(4.5%),胆漏2例(3.0%)。41例(62.1%)获随访,2例肝内胆管结石复发,1例仍有右上腹隐痛,其余随访结果优良。结论根据患者结石及狭窄的具体情况采用以肝段切除为主的联合手术是治疗肝胆管结石并狭窄的有效手段。

Associated Operations of Hepatic Segmentectomy for Hepatolithiasis Combined with Bile Duct Stricture

Objective To study the clinical effect of associated operations of hepatic segmentectomy for hepatolithiasis combined with bile duct stricture. Method The clinical data of 66 patients with hepatolithiasis and bile duct stricture were retrospectively analyzed. Results All of the operations succeeded. There were 5 cases of remnant stones after operation（7.6% ） ,3 cases of incisional infection（4.5% ）, and 2 cases of bile leakage（3.0% ）. In the 41 cases（ 62. 1% ） who were followed up, there were 2 cases recurred calculus and 1 case recurred bellyache in the right upper abdomen. Conclusion The associated operations of hepatic segmentectomy are effective methods to treat hepatolithiasis combined with bile duct stricture according to the individual specific conditions.