肝部分切除联合胆道镜治疗肝内外胆管结石的临床分析word格式论文.docxVIP

Clinical analysis of partial liver resection combined withIIIcholedochoscope for intrahepatic and extrahepatic bile duct stonesMajor: Hepatobiliary SurgeryPostgraduate: Luo YaobingSupervisor：Sun Chengyi[Abstract] Objective: To compare and analyse the clinical curative effect for intra- and extrahepatic bile duct stones with three surgical methods of partial hepatectomy combined exploration with choledochoscope,common bile duct exploration and T tube drainage and Roux-en-Y choledochojejunostomy,to discuss the effectiveness and superiority of partial hepatectomy combined choledochoscope for intra-and extrahepatic bile duct stones. Methods: A retrospective analysis of clinical data 241 cases patients with intra-and extrahepatic bile duct stones,from July 2009 to December 2013,compare and observe the rate of residual stone,stone recurrence and reoperation, the incidence of cholangitis for three groups of postoperative patients,then provide statistical analysis. Results: 241 cases of postoperative patients,the rate of residual stone in partial hepatectomy group(9.5%)is lower than the common bile duct exploration and T tube drainage group(29.4%)and Roux-en-Y choledochojejunostomygroup(38.2%)，and the difference had statistical significance(P0.05).We makefollow-up of 236 patients,the rate of stone recurrence in partial hepatectomy group(8.4%)is lower than the common bile duct exploration and T tube drainage group(17.1%)and Roux-en-Y choledochojejunostomy group(22.2%), and the difference had statistical significance (P0.05). the incidence of cholangitis in partial hepatectomy group(9.6%)is lower than the common bile duct exploration and T tube drainage group(19.1%)and Roux-en-Y choledochojejunostomy group(37%), and the difference had statistical significance (P0.05). reoperation, the rate of reoperation in partial hepatectomy group(2.4%)is lower than the common bile duct exploration andT tube drainage group(13.1%)and Roux-en-Y choledo -chojejunostomy group(11.1%), and the di