肝内外胆管结石合并肝硬化的围手术期处理

目的　探讨肝内外胆管结石合并肝硬化的围手术期处理。方法　对近 10年收治的 76例肝内外胆管结石的临床资料进行了回顾性分析。结果　根据术前检查 ,术前改善肝功能 (将肝功能C级转变为A级或B级 )、纠正凝血机制障碍、降低门静脉压力 ,术中精细操作 ,尽量减少失血 ,术后加强监护 ,继续保肝、支持治疗 ,手术后 69例恢复良好 ,15例残留结石 ,5例发生慢性肝衰竭 ,2例发生肾功能不全 ,均经保守治愈恢复。无死亡病例。结论　做好围手术期处理 ,肝内外胆管结石合并肝硬化患者尽早手术仍可获得良好效果。

Perioperative treatment of intra and extra hepatic cholelithinsis in patients with liver cirrhosis

Objective To study the perioperative treatment of intra-and extra-hepatic cholelithinsis in patients with liver cirrhosis . Methods The clinical data of intra-and extra-hepatic cholelithinsis in patients with liver cirrhosis in our hospital in resent 10 years was retrospectively analyzed. Results According to the preoperative examation, improving hepatic function(turn child class C to A or B), correcting the coagulation disturbance,decreasing portal vein pressure preoperatively,and proforming operation carefully to reduce bleeding,and giving support treatment and liver care treatment to improve the liver function further postoperatively etc were made.Fifteen cases remained stones, 5 cases appearred chronic liver failure,2 cases appearred kidney failure ,the other 69 cases recovered well. Conclusions If optimizing perioperative treatment is given, favorable effect might be obtained in intra-and extra-hepatic cholelithinsis in patients with liver cirrhosis.