摘要
对１９９０年１月～１９９５年１２月６年间我国部分省市区４６所医院收治的胆石病患者５５８２例进行统计分析。５５８２例中男１６９８例，女３８８４例，男∶女＝１∶２．２９；年龄１５～８４岁，平均４７．２岁。胆囊结石２７３５例（４８．９９％），其中单纯胆囊结石２２４８例（４０．２７％），合并胆总管结石４８７例（８．７２％）；伴急性胆囊炎５４例（１．９７％），急性胆管炎１８９例（６．９１％），阻塞性黄疸２１５例（７．８６％）。肝内外胆管结石２８４７例（５１．００％），其中肝外胆管结石１２８４例（２３．００％），左肝胆管结石６６８例（１１．９７％），右肝胆管结石３８４例（６．８８％），左右肝胆管结石５１１例（９．１５％）；合并急性重症胆管炎６８３例（２３．９９％），急性胆管炎１１６９例（４１．０６％），阻塞性黄疸４３１例（１５．１４％），胆汁性肝硬变２７８例（９．７６％）。胆囊结石组行单纯胆囊摘除术２６９７例（均为开腹手术），其中４８例加作Ｔ管引流；行胆肠吻合术３６例；Ｏｄｄｉ’ｓ括约肌成形术７例。胆管结石组行胆总管探查、取石及Ｔ管引流２２７５例（７９．９１％），行各类型胆肠吻合术５３４例（１０．７６％）；Ｏｄｄｉ’ｓ?
Five thousands five hundreds and eighty two patients with cholelithasis in 46 hospitals were collected through questionnaire and analysed, of which 2 735 cases were gallstones (accounted for 48.99%),and 2 847 cases were intra and extrahepatobiliary tract stones (accounted for 51.00%). In the gallstone group, there were 487 cases (8.72%) complicated with choledocholithasis, 54 cases (1.97%) complicated with acute cholecystitis, 189 cases (6.91%) with acute cholangitis, and 215 cases (7.86%) with obstructive jaundice. In 2 847 cases with intra and extrahepatobiliary tract stones, 1 284 cases were found to be extrahepatic duct stones (23.00%), 668 cases were left intrahepatic duct stones (1.97%), 384 cases were right intrahepatic duct stones (6.88%), and 511 cases stone in both sides (9.15%); complications in this group were acute severe cholangitis 683 cases (23.99%), acute cholangitis 1 169 cases (41.06%), obstructive jaundice 431 cases (15.14%), and biliary cirrbosis 278 cases (9.76%). The operative procedure for patients with gallstones were cholecystectomy (2 697 cases), chelangioduodenostomy or cholangiojejunostomy (36 cases), and Oddi's sphincteroplasty (7 cases); and for patients with intra and extrahepatobiliary tract stones were choledocholithotomy and T tubule drainage (2 275 cases), differecnt forms of choledochoenterostomy (534 cases), and Oddi's sphincteroplasty (38 cases). The postoperative complicatioin rate in patients with gallstones was 1.13%, with intra and extrahepatobiiary tract stones was 14.47%, mortality of the latter was 1.62%. The authors consider that cholecystectomy should be performed in elderly patients (over 50 years) with or without symptoms, and proper choice of operative procedure for hepatobiliary tract stones is important.
出处
《中国普外基础与临床杂志》
CAS
1998年第4期228-230,共3页
Chinese Journal of Bases and Clinics In General Surgery
