摘要
目的探讨肝切除联合术中应用胆道镜治疗肝内外胆管结石的临床治疗效果。方法 2014年12月~2016年11月对27例肝内胆管结石合并胆总管结石患者行肝切除联合胆道镜检查及取石,其中肝左外叶结石15例,左半肝结石6例,右后叶结石5例,右半肝结石1例,所有患者均合并胆总管结石。结果 27例患者均成功行肝切除术,其中24例患者通过肝断面胆管经胆道镜对肝内胆管及胆总管检查、取石,3例患者因胆总管结石嵌顿未成功,改行胆总管切开取石术+胆道镜检查取石+T管引流。手术时间118~168min,平均133min;术中出血量100~400ml,平均190ml。术后发生切口感染1例,发生胆漏2例,发生肝断面渗血1例,均经保守治疗治愈。术后随访患者3~24个月,平均18个月,均未见结石残留及复发。结论肝切除联合联合胆道镜治疗肝内外胆管结石临床治疗效果显著,具有极高的临床应用价值。
Objective To investigate the clinical effect of hepatectomy combined with choledochoscopy in the treatment of intrahepatic and extrahepatic bile duct stones. Methods From December 2014 to November 2016,27 patients with hepatolithiasis combined with common bile duct stones underwent hepatectomy combined with choledochoscopy and stone extraction. Of which 15 cases of left lateral hepatic calculi,6 cases of left hepatic calculi,5 cases of right posterior lobe calculi,1 case of right hepatic calculi,all patients were complicated with common bile duct stones. Results Twenty-seven patients underwent successfully hepatectomy,24 cases of patients with intrahepatic bile duct and choledoch was explored by choledochoscope through hepatic cross section,3 case was not successed to explore common bile duct due toincarceration of common bile duct stones. To perform Lithotomy of common bile duct ＋ choledochoscopy ＋ T tube drainage. operation duration was 118 - 168 min,mean 133min; The intraoperative blood loss was 100 - 400 ml,mean190ml. infection of incisional wound occurred in 1 case,bile leakage occurred in 2 cases and bleeding from the cut liver surface occurred in 1 case after operation,which were all resolved by conservative treatment. Over a follow-up of 3months to 24 months with an average of 18 months,no residual stones or new stone formation were found. Conclusion Liver resection combined with choledochoscopy in the treatment of intrahepatic and extrahepatic bile duct stones has a significant clinical effect. It has high clinical application value.
出处
《潍坊医学院学报》
2017年第4期296-298,共3页
Acta Academiae Medicinae Weifang
关键词
肝切除术
肝内外胆管结石
胆道镜
Hepatectomy
Intrahepatic and extrahepatic bile duct stones
Choledochoscopy
