门静脉高压症合并胆囊结石的手术治疗

目的　总结门静脉高压症合并胆囊结石 ,行脾切除、贲门周围血管离断术应同时行胆囊结石的手术治疗。方法　对 2 8例行脾切除、贲门周围血管离断术并同时对胆囊结石的手术资料进行回顾性分析。结果　胆囊切除 2 1例 ,胆囊大部切除 2例 ,胆囊切开取石、胆囊造瘘术 1例 ,此 2 4例均治愈。 4例未行胆囊切除仍有结石存在 ,术后 6个月及术后 12个月各有 2例出现发作性胆囊炎胆绞痛 ,其中 3例急诊胆囊切除术治愈 ;1例非手术治疗症状缓解。结论　门静脉高压症合并胆囊结石行脾切除、贲门周围血管离断术同时应手术治疗胆囊结石 ,可行胆囊切除术 ,胆囊大部切除术或胆囊切开取石、造瘘术

SURGICAL MANAGEMENT OF CHOLECYSTOLITHIASIS COMPLICATING PORTAL HYPERTENSION

Objective Summarizing operative method for cholecystolithiasis complicating portal hypertension while disconnection of cardiac portal-systemic venous shunt.Method Retrospective analyzing 28 patients receiving disconnection of cardiac portal-systemic venous shunt while treating cholecystolithiasis.Results Cholecystectomy 21 cases,subtotal cholecystectomy 2 cases,lithotomy of gallbladder and cholecystostomy 1 cases and all were cured.There was onset of cholecystitis and biliary colic in 4 patients at 6 and 12 months after operation respectively,3 patients received cholecystectomy in emergency,one patient recovered without operation.Conclusion Cholecystectomy should be performed while practicing disconnection of cardiac portal-systemic venous shunt for cholecystolithiasis complicating portal hypertension, and the operation includes cholecystectomy,subtotal cholecystectomy,lithotomy of gallbladder and cholecystostomy.