规则性肝段切除联合胆道镜取石治疗肝内胆管结石

【目的】探讨规则性肝段（叶）切除联合胆道镜取石治疗肝内胆管结石的方法及远期疗效。【方法】回顾性分析本院131例肝内胆总管结石患者采用规则性肝段（叶）切除、胆总管探查、T管引流术（术中联合胆道镜取石）治疗的临床资料。【结果】131例患者术后恢复良好，康复出院，无手术死亡。随访112例10个月至8年，93例（83．0％）症状消失，8侧（7．1％）术后结石残留，7例（6．3％）术后复发，5例（4．5％）胆道反复感染疼痛。【结论】规则性肝段（叶）切除联合胆道镜取石术安全可靠，可降低残石率、结石复发率，是目前治疗肝内胆管结石最有效方法之一。

Clinical Analysis of Regular Liver Segment Resection Combined with Choledochoscopic Stone Removing for the Treatment of 131 Patients with Hepatolithiasis

Objective]To explore the methods and long-term efficacy of regular liver segment（lobe） resection combined with choledochoscopic stone removing for the treatment of hepatolithiasis. Methods] Hepatoli- thiasis undergoing regular liver segment（lobe）, exploration of common bile duct and T-tube drainage（combined with choledochoscopic stone removing） in our hospital was summarized retrospectively. Results]All 131 pa- tients recovered well after operation and discharged from our hospital after the recovery. No one died during the operation. In the follow-up of Among 112 patients who were followed up for 10 months to 8 years, 93 patients（83.0%） had the disappearance of the symptoms, and 8 patients（7.1%） had the residual stones, and 7 patients（6.3%） had the recurrence and 5 patients（4.5%） had the infection and ache of biliary tract repeatedly. Conclusion]Regular liver segment（lobe） resection combined with choledochoscopic stone removing is safe and reliable, and can reduce the stone residue rate and the stone recurrence rate. Therefore, it is one of the most effective ways to treat hepatolithiasis.