摘要
目的探讨解剖性肝切除联合术中胆道镜治疗复杂肝内胆管结石的临床疗效。方法回顾性分析解放军第960医院(泰安院区)普通外科2005年5月至2015年7月手术治疗176例复杂肝内胆管结石患者一般资料、临床表现、结石分型、手术方式、手术并发症及随访情况等资料。结果无手术死亡病例,术后并发肺部感染、腹腔感染、胆瘘、肝功能不全等并发症31例(17.6%),其中残余结石18例(10.2%)。随访1~3年,手术优良率为94.4%(152/161),12例(7.5%)出现结石复发。结论解剖性肝切除联合应用术中胆道镜探查,可有效提高复杂肝内胆管结石的手术疗效、降低术后残石率和复发率,但应遵循"个体化"的手术原则。
Objective To study the clinical outcomes of anatomical hepatectomy combined with intraoperative choledochoscopy in treatment of complicated hepatolithiasis.Methods The clinical data of 176 patients with complicated hepatolithiasis who underwent operation at the Department of General Surgery of No.960 Hospital of PLA from May 2005 to July 2015 were analyzed retrospectively.The data included general data,clinical manifestations,types of stones,operative methods,postoperative complications and follow-up.Results There was no perioperative death.The postoperative complications which occurred in 31 patients(17.6%)included lung infection,intra-abdominal infection,bile leakage,and liver failure.Eighteen patients(10.2%)were found to have residual stones.After a follow-up which ranged from 1 to 3 years,152 patients(94.4%)had good clinical outcomes.Recurrent stones were found in 12 patients(7.5%).Conclusion Anatomical hepatectomy combined with intraoperative choledochoscopy improved operative outcomes in patients with complicated hepatolithiasis and decreased residual stone and recurrence rates.
作者
何少武
吴波
徐洁
康俊升
乔峰
刘杰
刘凯文
He Shaowu;Wu Bo;Xu Jie;Kang Junsheng;Qiao Feng;Liu Jie;Liu Kaiwen(Department of General Surgery,No.960 Hospital of PLA,Taian 271000,Shandong Province,China)
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2019年第9期681-684,共4页
Chinese Journal of Hepatobiliary Surgery
关键词
肝胆管结石病
解剖性肝切除
胆道镜
Hepatolithiasis
Anatomical hepatectomy
Choledochoscope
