肝叶切除治疗复杂原发性肝胆管结石的临床研究.docVIP

肝叶切除治疗复杂原发性肝胆管结石的临床研究 　　doi：10.3969/j.issn.1007-614x.2014.21.32 　　摘 要 目的：探讨肝叶切除治疗复杂原发性肝胆管结石的临床疗效。方法：2013年2月-2014年3月收治肝叶切除治疗的原发性肝胆管结石患者55例，所有患者均经B超及CT检查检查确诊，均行胆道探查肝叶切除术进行治疗。结果：本组55例患者均行肝切除手术，所有患者均成功取石，手术时间（185.5±50.6）分钟，术中出血（250±200）ml，术后无死亡，术后发生并发症3例，其中切口感染1例，发生胆瘘1例。经过3～15个月的随访，术后复发1例，复发率1.8%，优良率98.2%。结论：肝叶切除治疗复杂原发性肝胆管结石复发率低，疗效显著，值得推广。 　　关键词 肝叶切除术 复杂原发性肝胆管结石 胆道探查 　　Clinical study on lobectomy of liver in the treatment of complicated primary hepatic bile duct stones 　　Yang Lanfang 　　Department of Hepatobiliary and Pancreatic Surgery，the First Affiliated Hospital of Fujian Medical University，350005 　　Abstract Objective：To investigate clinical effect of lobectomy of liver in the treatment of complicated primary hepatic bile duct stones.Methods：55 cases with primary hepatic bile duct stones who were treated with hepatic lobectomy were selected from February 2013 to March 2014.All the cases were diagnosed by the B ultrasound and CT scan examination.They were underwent exploration of biliary tract lobectomy of liver.Results：55 cases in this group were underwent liver resection operation.Stone extraction of all patients were successful.The operation time was（185.5±50.6） minutes.The amount of bleeding in operation was（250±200） ml.There was no death after operation.Postoperative complications occurred in 3 cases，including 1 cases of incision infection，1 cases of biliary fistula.After 3～15 months of follow-up，1 cases of recurrence，the recurrence rate was 1.8%.The rate of excellent and good was 98.2%.Conclusion：Lobectomy of liver in the treatment of complicated primary hepatic bile duct stones had low recurrence rate，and significantly effect，so it is worthy of promotion. 　　Key words Lobectomy of liver；Complicated primary hepatic bile duct stones；Exploration of biliary tract 　　复杂原发性肝胆管结石（primary intrahepatic stone）病变复杂[1]，是胆道外科的复杂疾病之一，由于结石在肝内有很强的节段性分布，因此肝叶切除手术治疗才能达到彻底清除病灶的目的。为探讨肝叶切除治疗复杂原发性肝胆管结石的临床疗效，2013年2月-2014年3月收治肝叶切除治疗的原发性肝胆管结石患者55例，进行总结和分析，现报告如下。 　　资料与方法 　　2