摘要
目的:探讨肝叶(段)切除联合T管引流术与高位胆管切开取石联合T管引流术治疗肝内胆管结石效果;方法:选取2017年1月至2018年12月240例行手术治疗的肝内胆管结石患者作为研究对象,按照选择的手术方式分为A、B两组,A组患者进行肝叶(段)切除联合T管引流术治疗,B组患者进行高位胆管切开取石联合T管引流术治疗,比较两组患者的临床疗效、围手术期并发症发生情况、随访术后1年结石残余情况、随访2年取净结石情况、随访复发情况。结果:A组患者的临床疗效总有效率为94.81%、围手术期并发症发生率为24.44%、取净结石率为77.78%,较B组高(P<0.05);结石残余率为8.89%、结石复发率10.37%,较B组降低(P<0.05)。结论:肝叶(段)切除联合T管引流术治疗肝内胆管结石效果较好,但是围手术期并发症较高,需要综合考虑,合理、正确选择手术方式。
Objective:To compare the clinical effect of hepatic lobe(segment)resection combined with T-tube drainage and high bile duct resection with T-tube drainage for intrahepatic bile duct stones.Methods:240 patients with intrahepatic bile duct stones,who underwent surgery from January 2017 to December 2018,were enrolled as the subjects of the study and divided into group A and group B according to the surgical methods adopted.Group A was treated with hepatic lobe(segment)resection combined with T-tube drainage,and group B was treated with high bile duct resection with T-tube drainage,with such indicating factors compared between the two groups as the clinical efficacy,perioperative complications,residual stones in 1 year follow-up after the operation,net calculi during 2 years follow-up,and recurrence.Results:In group A,the total clinical efficacy rate was 94.81%,perioperative complication rate was 24.44%and net stone rate was 77.78%,higher than those in group B(P<0.05).The stone residual rate was 8.89%and the recurrence rate was 10.37%in group A,significantly lower than that in group B(P<0.05).Conclusion:Hepatic lobe(segment)resection combined with T-tube drainage is more effective in the treatment of intrahepatic bile duct stones,but with the high incidence of perioperative complications,and it is necessary to take comprehensive consideration to choose to adopt the proper and correct surgical method.
作者
杨帆
李国炜
罗庚
王浪
YANG Fan;LI Guowei;LUO Geng;WANG Lang(Department of Hepatobiliary Surgery,The First People's Hospital of Guiyang, Guiyang 550002,China)
出处
《包头医学院学报》
CAS
2019年第6期34-36,共3页
Journal of Baotou Medical College
关键词
肝叶(段)切除
高位胆管切开取石
T管引流术
肝内胆管结石
临床疗效
Hepatic lobe(segment)resection
High bile duct incision
T-tube drainage
Intrahepatic bile duct stones
Clinical efficacy
