肝切除配合纤维胆道镜治疗肝胆管结石25例

目的 探讨肝胆管结石病人的最合理外科治疗。方法 回顾性分析1996年4月至2000年2月手术配合纤维胆道镜治疗肝胆管结石25例。结果 25例肝胆管患者，左外叶切除21例，左半肝切除3例，右后叶切除1例，3例同时附加胆总管空肠Roux—en—Y端侧吻合，无手术死亡。术后结石残留3例，经纤维胆道镜均顺利取出。结论 在经济欠发达地区肝胆管结石病人就诊时结石分布并不按严格的叶段分布；术中纤维胆道镜可以发现切除肝以外的散在结石，可大大降低结石残留率；肝切除治疗肝胆管结石有可能预防迟发性肝胆管癌的发生。

THE TREATMENT OF HEPATOLITHIASIS BY HEPATECTOMY AND CHOLEDOCHOFIBERSCOPE(25 CASES REPORT)

Objective To explore the optimal treatment of hepatolithiasis.Methods The data from 25 cases with hepatolithias,who underwent hepatectomy and choledochofiberscope from Apr 1996 to Feb 2000,were retrospectively analyzied.Results 21 patients adopted hepatectomy for left lateral lobe,3 for left lobe and 1 for right posteriol lobe.An additional Roux en y choledochojejunostomy was performed for 3 patients.The operation mortality is nil.Residual calculi in 3 patients after operation were taken out smoothly by choledchofiberscope.Conclusion The intrahepatic calculi doesn't distribute with aratomic segments or lobes strictly.Residual calculi decrease greatly since scattered stones of removal liver are discovered by choledochofiberscope in operation.Hepatectomy to cure hepatolithiasis would probably prevent delayed cholangiocarcinoma.