【摘要】 目的评价肝切除联合纤维胆道镜治疗肝胆管结石的疗效。方法回顾性分析5年间因肝胆管结石接受外科治疗的469例临床资料,按治疗方式和分组比较其疗效。结果分析采用 X2检验。结果 5年间因肝胆管结石接受手术治疗者469例,随访412例(占87．8％),术后随访 6个月至5年(平均3年6个月)。肝切除组与胆道探查组的残石率、结石复发率、再手术率分别为 5．1％和14．8％(X2=9．32,P<0．01)、4．5％和14．8％(X2=11．24,P<0．01)、5．1％和16．0％(X2= 11．48,P<0．01);使用纤维胆道镜组与未使用纤维胆道镜组的残石率、结石复发率、再手术率分别为 4．4％和16．1％(X2=15．17,P<0．01)、3．8％和16．1％(X2=17．98,P<0．01)、4．1％和18．3％(X2= 21．52,P<0．01)。结论肝切除联合纤维胆道镜治疗肝胆管结石可明显提高肝胆管结石的疗效。更多还原

【Abstract】 Objective To evaluate the effect of surgical therapy for hepatolithiasis by hepatectomy and choledochofiberscopy. Method We retrospectively analyzed hepatolithiasis patients in our hospital during the past 5 years, comparing the therapeutic effect of different surgical modality. Data were analyzed by chi-square test. Result A total of 469 patients underwent surgical treatment, 412(87.85%) cases were followed up for an average of 3 years and 6 months. The residual calculus rate was 5. 14% and 14. 81% (x2 =9.32,P<0.01),the recurrence rate of calculus was 4.53% and 14.81%(x2=11.24, P <0.01),reoperation rate was 5. 14% and 16. 05% ( x2 = 11.48,P<0.01) in hepatectomy group and non-hepatectomy group respectively; The residual calculus rate was 4.39% and 16. 13% (x=15. 17, P <0. 01) , the recurring rate of calculus was 3. 76% and 16. 13% ( x2 = 17. 98 , P < 0. 01) , reoperation rate was 4. 08% and 18. 28% (X2=21. 52, P < 0. 01 ) in patients undergoing choledochofiberscopy and without, respectively. Conclusion Use of choledochofiberscopy in combination with hepatectomy effectively improves therapeutic efficacy of surgical treatment for hepatolithiasis.更多还原