肝叶切除治疗肝内胆管结石的疗效分析

目的探讨肝叶切除术治疗肝内胆管结石的有效性。方法回顾性分析63例肝内胆管结石行肝叶切除治疗患者的临床资料。结果全组患者均痊愈出院，无手术死亡病例，平均住院30．5d。术后发生并发症9例，占14．3％。其中膈下感染或脓肿2例，胆瘘2例，切口感染4例，胸腔积液1例。结石残留7例，占11．1％，其中左肝内叶残留结石4例，右肝后叶残留结石3例。全组患者62例获随访6个月至8年，随访率为98．4％，术后复发2例，优良率96．8％。结论肝叶切除术是治疗肝内胆管结石较好的方法，注重术前定位诊断和围手术期处理、手术方法和术式选择可明显降低残石率，减少并发症的发生。

Clinical effects of partial hepatectomy In treating intrahepatolithiasis

Objective To evaluate the clinical efficacy of partial hepatectomy in treating intrahepatolithiasis. Methods The data of 63 cases with partial hepatectomy were retrospectively evaluated. Results All operations were successful. Mean hospital stay was 30.5d. Complications were found in 9 cases (14.3%), including 2 cases of sub-phrenic abacess,2 cases of biliary fistula,4 cases of wound infectiun,1 case of pleural effusion. Residual stones were found in 7 cases (11.1%) ,4 were in left hepatic lobe,3 were in right. 62 cases (98.4%) were followed for 6 months to 8 years. Stones recurred in 2 cases. Conclusion Partial hepatectomy is effective for the treatment of intrahepatoli-thiasis with low residual stone rate.