左肝外叶切除联合胆道镜治疗肝内胆管结石的临床观察

目的探讨左肝外叶切除联合胆道镜治疗肝内胆管结石的临床效果。方法将2009年1月～2010年1月间在我院手术治疗的肝内胆管结石患者30例给予左肝外叶切除联合胆道镜治疗,随访治疗效果。结果本组疗效评定为优者15例,评定为良者12例,效果差者3例,优良率为90.00%。术后l例发生膈下感染,l例发生肺部感染,2例发生切口感染,并经处理后痊愈。术后2个月胆道镜检查显示1例左肝内叶结石合并胆道狭窄者发现结石,其余病例均未发现结石残留。本组无死于胆管炎或发生与胆管炎有关的并发症者。结论左肝外叶切除联合胆道镜治疗肝内胆管结石的临床效果确切,临床应合理选择应用。

CLINICAL RESEARCH ON LEFT EXTERNAL LOBE LIVER RESECTION COMBINED WITH CHOLEDOCHOSCOPE FOR INTRAHEPATIC DUCT CALCULI

Objective To investigate the effect of left external lobe liver resection combined with choledo- choscope for intrahepatic duct calculi. Methods The 30 cases with intrahepatic duct calculi in our hospital from Jan- uary in 2009 to January in 2010 were treated by left external lobe liver resection combined with choledochoseope,and the effect was followed -up. Results There were 15 cases with excellent effect,12 cases with fine effect and 3 cases with bad effect, and the fineness rate is 90.00%. There were 1 case with infection under diaphragm, 1 case with pul- monary infection and 2 cases with postoperative infection after operation, and all of them were cured by treatment. The choledochoscopic examination showed that all of them were without residue calculi except 1 cases who was with biliary tract stenosis. There was no case died of cholangitis and other complications. Conclusion The effect of left external lobe liver resection combined with choledochoscope for intrahepatic duct calculi is obvious, so it is worth being used reasonably.