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目的探讨肝内胆管结石合并胆道出血的诊治方法。方法对1982～1992年收治的32例肝内胆管结石合并胆道出血病人进行回顾性分析。结果32例病人中14例为肝内胆管自发性出血，均采用手术治疗，止血率为100％，随访1年无复发出血，18例为手术后出血，3例经保守治疗治愈，15例经保守治疗无效后采用手术治疗，13例止血成功，2例死亡。结论对肝内胆管结石合并自发性胆道出血应及时手术，在止血同时注意处理原发病变。手术后的胆道出血可先采取非手术治疗，部分病人可取得较好的疗效；非手术治疗无效者，应积极再手术治疗。

Diagnosis and management of hepatolithiasis complicated with hernobilia

Objectives To investigate the diagnosis and treatment of hepatolithiasis complicated with hemobilia. Mothods The data of 32 patients with hepatolithiasis complicated with hemobilia from 1982 to 1992 were reviewed.Fourteen cases were spontaneous hemobilia. The others were postoperative hemobilia.Results All of the 14 cases of spontaneous hemobilia underwent surgical operation including partial liver resection, hepatic arterial ligation, etc, to successfully stop bleeding. Eighteen cases of postoperative hemobilia accepted conservative therapy ,bleeding was stopped in 3 of 18 cases.Fifteen patients who failed in conservative therapy accepted reoperation. Among them, bleeding was stopped in 13 cases and 2 cases died. Conclusion Surgical management is recommended for the patients with hepatdithiasis complicated with spontaneous hemobilia. Conservative therapy is effective for some of postoperative hemobilia. Reoperation should be performed in patients failed in conservative therapy.