肝内胆管结石的手术治疗

目的研究肝内胆管结石的手术治疗方式及效果。方法回顾性分析近14年来手术治疗肝内胆管结石的临床表现、治疗方式及效果。结果362例中行肝部分切除162例，术后残石率16．7％，肝切除组与单纯取石组残石率差异显著，有统计学意义（P〈0．01），围手术期并发症差异无统计学意义（P〉0．05），效果优良率肝切除组优于单纯取石组，但差别无统计学意义（P〉0．05）。结论肝部分切除治疗肝内胆管结石效果优于单纯取石组，但切除范围应足够，同时矫正胆管狭窄，减少残余结石。

Surgical Treatment of Hepatolithiasis

Objective To evaluate the surgical measurement and effect of surgical treatment for hepatolithiasis.Methods 362 patients with hepatolithiasis were surgically treated in our hospital in the past 14 years.The clinical findings,distributions of stones,patterns of operation,postoperative complications and residual stones were collected and retrospectively analyzed.Results Among them 162 cases were partial hepatectomy,the incidence of residual stone was 16.7%.Patients with hepatectomy had significantly less incidence of residual stone(16.7% vs 41%,P<0.01) and had better therapeutic result(86% vs 76.8%,P>0.05)than the patients with single choledochotomy.The postoperative complications of hepatectomy was higher but not signiticantly different(5.6% vs 2.5%,P>0.05).Conclusion Hepatectomy is the most preferable in the treatment of hepatolithiasis.But the scope of hepatectomy must be enough and biliary stricture must be plastic operated,which can help to reduce the incidence of residual stone.