左肝叶切除治疗肝内胆管多发性结石(附84例报告)

目的总结左肝叶切除治疗肝内胆管多发性结石的经验。方法回顾性分析肝叶切除治疗84例左侧肝内胆管多发性结石患者的术前评估资料、手术方式、治疗效果及并发症等情况。结果84例患者中,左半肝切除34例,肝左外叶切除26例,肝段切除24例。左半肝切除术临床效果(结石残留率、疗效优良率、结石复发率)明显优于左外叶和肝段切除术(P<0.05)。左半肝切除术围手术期白蛋白水平、手术时间及术中出血量、并发症与其他手术方式无差异(P>0.05)。结论左半肝切除是治疗左侧肝内胆管多发性结石的有效方法。

Left Hepatic Lobectomy for Treating the Multiple Calculi in Intrahepatic Bile Duct

Objective To summarize the experience with left hepatic lobectomy for treating the multiple calculi in intrahepatic bile duct. Methods The clinical datas of 84 patients with multiple calculi in intrahepatic bile duct who underwent left hepatic lobectomy were ana lyzed retrospectively. Results 34 cases were treated by left hemihepatectomy,26 cases were treated by hepatic left lateral lobectomy,24 cas es were treated by hepatic segment resection. The treatment effects of left hemihepatectomy (the rate of residual stones,the rate of therapeu tic fine effect,the relapse rate of stones) were significantly better than the others (P <0.05),but there was no significant difference in serum albumin,operational time,intraoperative blood loss,and postoperative complications among these groups (P >0.05). Conclusions Left hemi hepatectomy is an effective method of treating the multiple calculi in intrahepatic bile duct.