肝叶切除术治疗肝内结石254例临床分析

为探讨肝内切除术治疗肝内结石的效果，分析７年来采用肝切除术治疗２５４例肝内结石的术前检查、结石的部位和分布情况，手术方式、手术后并发症及结石残留等情况，加以归纳总结。结果表明，肝内结石以左肝较多（１５９例），全肝结石其次（７８例）；肝切除仍以左外叶及左半肝切除为主（９０％）；有１８．９％的病例有结石残留；４９例出现手术后并发症；手术死亡２例，占０．７９％；４例伴有胆管癌变；全组治疗效果良好。肝切除

Management of hepatolithiasis by hepatectomy with clincal analysis 254 cases.

To assess the effect of hepatectomy in management of hepatolithiasis.254 cases of hepatolithiasis treated with hepatectomy in our hospital over past 7 years were analysed retrospectively,including preoperative examinations,location and distribution of stones,patterns of operation,postoperative complications,and residual stones.Left hepatolithiasis was the most common pattern(159 cases),followed by entire hepatolithiasis(78 cases).Of the operative patterns,left lateral lobectomy and left hepatecomy were most commonly employed(90%).18 9% cases had residual stones,and postoperative complications occurred in 49,including 2 deaths(mortality 0 79%)and malignant change in 4.The operative outcome was good.Hepatectomy is the main technique in management of hepatolithiasis,but still requires in combination with plasty of stenotic intrahepatic bile ducts and cholangiojejunostomy to reduce the incidence of residual stones and recurrence.