【摘要】 目的:探讨胆囊切除术后残余胆囊结石的诊断、治疗和预防。方法:2001年1月~2011年1月以来,某医院共进行胆囊切除术631例,所有患者术后进行相应检查,其中18例患者因残余胆囊结石需要再次进行手术治疗,患者在距离首次手术3个月~3年后进行再次手术,术式选择剖腹残余胆囊切除。并选取同一时间段内行胆囊切除术后没有残余胆囊患者18例作为对照组,超声检查比较两组的胆总管直径。结果:残余胆囊结石的发生率为2.85%。残余胆囊组的胆总管直径为(8.1±1.02)mm,对照组的胆总管直径为(6.0±0.62)mm,两组差异具有统计学意义(P<0.05)。结论:胆囊切除术后患者再次出现右上腹绞痛、发热、黄疸时,应该高度警惕残余胆囊结石,并采用B超、CT等检查进行检查,若存在残余胆囊,其胆总管宽度将大于无残余胆囊患者。手术成功关键在于是否有良好的麻醉、手术野暴露和细致的解剖。更多还原

【Abstract】 Objective:To investigate the diagnosis,treatment,and prevention of remanent gal lstone after cholecystectorny.Methods:There were 631 patients who have had cholecystectorny in our hospital fromJ anuary 2001 toJ anuary 2011.All of them had postoperative exarni nation.Among them,18 need reoperation because of remanent gallstone.They had reoperations of open remanent cholecystectorny 3 months to 3 years later after the first operation.At the same time,18 patients who had cholecystectomy but had no remanent gallstone after operation were selected as control group.Ultrasonography was made to make a corrparison of two groups’ width of choledoch.Results:The incidence rate of remanent gallstone was 2.85%.The total width of chol edoch in remanent gallstone group was(8.1 ± 1.02) mm while it was(6.0 ± 0.62)mmin control group.The variation had statistical significance(P<0.05).Conclusion:When the patients who have had chol ecystectorny have epigastric pain,a fever,or jaundice,we should pay attenti on in case of remanent gallstone Patients should also have B-ultrasonic and CT.If they have remanent gallstone,their width of choledoch will be wider than others.The key factors of successful operation are good anesthesia,full exposure,and careful anatomy.更多还原