肝叶切除治疗肝内胆管结石临床体会

目的探讨肝叶切除治疗肝内胆管结石的方法及疗效。方法回顾性总结1992年12月至2004年12月间肝叶切除治疗112例肝内胆管结石的经验与体会。结果本组无手术死亡,术后并发症有胆漏3例(2.7%)、膈下感染5例(4.5%)、腹腔脓肿2例(1.8%)和肝衰1例(0.9%)等。本组获随访者103例,随访时间4月至13年,平均7年3月,76.7%术后症状消失,工作生活正常,17.5%偶有轻度胆管炎发作,5.8%仍反复发作严重胆道感染。结论肝叶切除术是治疗肝内胆管结石最有效的手段。

Clinical experience of hepatic lobectomy for the treatment of hepatolithiasis

Objective To explore the method and effect of hepatectomy for the treatment of the patients with hepatolithiasis.Methods Retrospective summary was made on 112 patients suffering from hepatolithiasis undergone different types of hepatectomy from Dec.1992 to Dec.2004.Results None patient died in operation and the majority of postoperative complications were biliary fistulas(2.7%),subphrenic infection(4.5%),peritoneal abscesses(1.8%) and liver failure(0.9%).Long-term follow up on 103 patients at a median of 7.3 years showed that 76.7% were without symptom and could work as usual,17.5% had occasional mild attacks of cholangitis,5.8% had severe cholangitis requiring further surgical intervention.Conclusion Hepatectomy is the most effective treatment for hepatolithiasis.