腹腔镜下左半肝切除术

肝内胆管结石是指结石位于肝内胆管。这种疾病在西方不多见而易发于东亚地区,(肝内胆管中的)结石和(或)狭窄等因素使肝内胆管反复发生化脓性感染,不仅加重胆管的狭窄和阻塞,并加重肝实质的损害,导致肝纤维化,萎缩;感染急性发作时又易发生菌血症、感染性休克、胆源性肝脓肿、胆管溃疡致胆道出血,病变晚期则可发生胆汁性肝硬化、门脉高压症等一系列严重的后果。近年来,因为左半肝较容易操作的解剖位置使得腹腔镜下左半肝切除术在肝胆外科手术中很快得到关注,研究和临床经验表明左半肝切除术用于肝胆管结石症,兼具解除肝管梗阻(结石,尤其合并存在的肝胆管狭窄)和去除化脓性感染病灶的双重效果,有效地提高了肝胆管结石的远期治疗效果。

Laparoscopic left liver resection

Hepatolithiasis is the presence of gallstones in the biliary ducts of the liver .Treatment is usually surgical .It is rare in Western countries , but prevalent in East Asia .The stones and/or stenosis could result in recurrent intra-hepatobiliary pyogenic infection , not only could increase the straitness and obstruction of biliary ducts , but also could exacerbate liver damage , fibrosis and atrophy afterwards .During the period of acute infection , patients are susceptible to bacteremia , septic shock , biliary hepatic abscess and even biliary tract bleeding caused by ulcer of bile duct .Advanced cases might combine with biliary cirrhosis, portal hypertension and other serious consequences .In recent years, laparoscopic left liver resection rapidly gained the interest of hepatobiliary surgeons due to the feasibility and safety of left liver resection.Studies and clinical experience showed that left liver resection could cure hepatolithiasis effectively with satisfactory long-term outcome.It also could help to relief the hepatic duct obstruction ( stones, especially cases with bile duct stenosis ) and to remove the focus of purulent infection .