高龄肝胆管结石病人的外科手术治疗

目的:探讨70岁以上高龄肝胆管结石病人的临床特点和提高外科手术治疗的疗效.方法:对1993年1月至2002年12月间收治的98例高龄肝胆管结石病人进行回顾性分析.结果:全组98例,治愈92例,治愈率为93.9%;死亡6例,死亡率为6.1%.急症手术29例,择期手术69例,手术并发症发生率为35.7%.并存疾病37例,占总病例数的37.8%.结论:急症手术以肝、胆总管切开取石、T管引流为主要术式,择期手术可附加胆肠吻合或肝部分切除.只要手术时机和术式选择得当,同时做好并存疾病的处理,高龄肝胆管结石手术治疗同样可取得满意疗效.

SURGICAL TREATMENT FOR PATIENTS OF ADVANCED AGE WITH HEPATOLITH

Objective:To evaluate the clinical features and promote the curative effect of the surgical treatment in people of advanced age with hepatolith Methods:Ninety eight cases of advanced age with hepatolith from Jan 1993 to Dec 2002 were retrospectively analysed Results:Ninety two cases were cured and 6 died in total 98 cases with the cure and mortality rates 93 9% and 6 1% respectively Emergency operation was performed in 29 cases and selective one in 69 The incidence of complications was 35 7% in this group Simultaneous disorders appeared in 37 cases which accounted for 37 8% of total Conclusion:The main operation programs are HCD or BCD exploration and stone removal,plus T tube drainage for emergency The procedure mentioned above plus choledochojejunostomy or hepatic segmentectomy is for selective patients When operation opportunity and program are chosen properly,meanwhile simultaneous diseases are treated promptly,the results should be satisfactory for patients of advanced age with hepatolith