摘要
目的探讨双侧肝段或肝叶切除术治疗复杂性肝内胆管结石的近期和远期效果。方法回顾性分析我院2006年8月至2017年3月来行左右双侧肝段或肝叶切除术治疗复杂性肝内胆管结石的26例患者,分析其结石部位及分布情况、手术方式、术后并发症、结石即时清除率及最终清除率等情况。结果本组病例无手术死亡,术后并发症(单一或多个并发症)发生率为46.15%(12/26)。肝切除术后即时结石清除率为69.2%(18/26),经术后胆道镜取石,最终结石清除率为88.4%(23/26)。随访23例,时间为3个月至130个月,结石复发率为4.3%,术后胆管炎发生率为4.3%(中位随访时间为30个月)。结论双侧肝段或肝叶切除术治疗复杂性肝内胆管结石是安全有效的,术后效果良好。
Objective To explore the short-term and long-term effects of bilateral liver segment or lobectomy in the treatment of complicated intrahepatic bile duct stones.Methods A retrospective analysis of 26 patients with complicated intrahepatic bile duct stones underwent bilateral hepatic segment or lobectomy from August 2006 to March 2017 in the First Affiliated Hospital of Anhui Medical University,and the location of the stones were analyzed And the distribution,surgical methods,postoperative complications,immediate stone clearance rate and final clearance rate.Results There were no surgical deaths in this group of patients,and the incidence of postoperative complications(single or multiple complications)was 46.15%(12/26).The immediate stone clearance rate after hepatectomy was 69.2%(18/26),and the final stone clearance rate was 88.4%(23/26)after choledochoscopy.23 cases were followed up for 3 months to 130 months,the stone recurrence rate was 4.3%,and the incidence of postoperative cholangitis was 4.3%(median follow-up time was 30 months).Conclusion Bilateral liver segment or lobectomy is safe and effective for the treatment of complicated intrahepatic bile duct stones,and the postoperative effect is good.
作者
方强
陈江明
濮天
陈子祥
刘付宝
FANG Qiang;CHEN Jiang-ming;PU Tian(Department of General Surgery,First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)
出处
《肝胆外科杂志》
2022年第5期342-344,共3页
Journal of Hepatobiliary Surgery
基金
安徽省科技重大专项(202103a07020008)。
关键词
肝内胆管结石
肝切除
疗效
intrahepatic bile duct stones
hepatectomy
effect
