CAJ | 학술논문

目的探讨伴有终末期胆病的复杂性肝内外胆管结石的手术时机和手术方式.方法对32例伴有终末期胆病的复杂性肝内外胆管结石施行了手术治疗,手术方式包括胆总管切开取石"T"管引流术,胆囊切除、胆总管切开取石"T"管引流术,胆囊切开取石、胆囊造口术、胆总管切开取石"T"管引流术,原位肝移植术.结果所有病人无手术死亡,术后并发症发生率为46.88%.术后疗效优7例,良14例,差11例.结论此类病人肝脏功能储备差,术中极易发生大出血,术后并发症发生率高.手术前应完善围术期处理,以简单术式为主,解决引起主要症状的结石.
목적 탐토반유종말기담병적복잡성간내외담관결석적수술시궤화수술방식.방법 대32례반유종말기담병적복잡성간내외담관결석시행료수술치료,수술방식포괄담총관절개취석"T"관인류술,담낭절제、담총관절개취석"T"관인류술,담낭절개취석、담낭조구술、담총관절개취석"T"관인류술,원위간이식술.결과 소유병인무수술사망,술후병발증발생솔위46.88%.술후료효우7례,량14례,차11례.결론 차류병인간장공능저비차,술중겁역발생대출혈,술후병발증발생솔고.수술전응완선위술기처리,이간단술식위주,해결인기주요증상적결석.
Objective To investigate the timing and procedures of operation for patients with cholelithiasis complicated with end biliary disease.Methods Thirty-two patients with cholelithiasis complicated with end biliary disease were surgically treated in our hospital.The operative procedures included choledochotomy with T tube insertion,cholecystectomy and choledoehotomy with T tube insertion,cholecystectomy and choledochotomy with T tube insertion and hepatic transplantation.Results No operative death occurred and the incidence of complications was 46.8%.Seven patients were better,14 good and 11 poor in therapeutic efficacy.Conclusion The patients can have major hemorrhage during operation for their poor hepatic function and high incidence of complications.Simple operative procedures should be used to mainly remove the stone causing the major symptoms.