【摘要】 目的探讨规则性肝切除联合术中纤维胆道镜在肝内胆管结石治疗中的价值。方法对2003年1月~2009年12月我院外科采用规则性肝切除联合术中纤维胆道镜治疗肝内胆管结石的30例病人的临床资料进行回顾性分析。结果所有病例均根据结石部位行规则性肝切除和术中纤维胆道镜探查取石。其中,左肝外叶切除术11例,左半肝切除16例,右后叶切除2例,Ⅴ+Ⅵ段切除1例。另外,17例合并胆总管结石行胆总管探查T管引流术,2例联合行胆管空肠Roux-y吻合术。本组病例无围手术期死亡,术后并发症率为13.3%,结石残留率为6.7%。结论规则性肝叶(或段)切除是治疗肝内胆管结石的有效手段,术中使用纤维胆道镜可以明显降低结石残留率。更多还原

【Abstract】 Objective To explore the efficiency of regular hepatectomy combined with intraoperative fibercholedochoscope for hepatolithiasis.Methods The data of 30 patients with hepatolithiasis from January 2003 to December 2009 were analyzed retrospectively.Results All the cases were treated by regular hepatotomy combined with fibercholedochoscope according to the stone location.The types of hepatectomy included left lateral hepatectomy(11 cases),left hemibepatectomy(16 cases),right posterior lobe hepatectomy(2 cases),segmentⅤand segment Ⅵ hepatectomy(1 case).Additional external drainage for common bile duct were done on 17 cases and cholangiojejunostomy(Roux-en-y)on 2 cases.No death occurred in perioperative period.Postoperative complications occurred in 13.3% cases.The rate of residual stones was 6.7%.Conclusions Regular hepatotomy is the most effective treatment for hepatolithiasis,and the application of fibercholedochoscope may significantly reduce the rate of residual stones.更多还原