肝切除术治疗肝内胆管结石98例临床分析
간절제술치료간내담관결석98례림상분석
Hepatectomy for hepatolithiasis: an analysis of 98 eases
  • 万方数据
    中华普通外科杂志 중화보통외과잡지
    CHINESE JOURNAL OF GENERAL SURGERY
    2010年 3期 217-220 ,共4页

    赵海涛%刘立国%缪若羽%卢欣%徐意瑶%杜顺达%徐海峰%迟天毅%杨华瑜%杨志英%毛一雷%桑新亭%钟守先%黄洁夫

    조해도%류입국%무약우%로흔%서의요%두순체%서해봉%지천의%양화유%양지영%모일뢰%상신정%종수선%황길부

    胆结石%肝切除术 膽結石%肝切除術
    담결석%간절제술
    Cholehtiffasis%Hcpatectomy
    目的 探索肝内胆管结石经肝切除治疗患者的疗效和预后情况.方法 回顾性分析1984年4月至2009年3月北京协和医院经肝切除治疗的98例肝内胆管结石患者的临床资料.结果 本组98例患者中男女比例1:1.7,中位年龄55岁.58例(59.2%)既往接受过治疗,其中手术治疗50例.单纯左肝结石88例(89.8%),单纯右肝结石2例(2.0%),左右均受累8例(8.2%);51例(52.0%)合并肝外胆道结石,30例(30.6%)合并胆道狭窄,28例(28.6%)有既往胆道蛔虫病病史,5例(5.1%)合并胆道恶性肿瘤.全部病例均根据结石部位行肝脏部分切除术,8例双侧受累者,行左半肝切除、右肝管取石术.术后出现并发症14例(14.3%),围手术期死亡2例(2.0%).随访超过1年且未合并肿瘤者78例(79.6%),疗效优良率为91.0%,结石残存率和复发率均为2.0%.结论 肝切除术治疗既能清除结石,又能切除病变的胆道,具有结石残存率低和复发率低的优点,同时能对胆道恶性肿瘤早诊早治,是治疗肝内胆管结石的重要手段.
    목적 탐색간내담관결석경간절제치료환자적료효화예후정황.방법 회고성분석1984년4월지2009년3월북경협화의원경간절제치료적98례간내담관결석환자적림상자료.결과 본조98례환자중남녀비례1:1.7,중위년령55세.58례(59.2%)기왕접수과치료,기중수술치료50례.단순좌간결석88례(89.8%),단순우간결석2례(2.0%),좌우균수루8례(8.2%);51례(52.0%)합병간외담도결석,30례(30.6%)합병담도협착,28례(28.6%)유기왕담도회충병병사,5례(5.1%)합병담도악성종류.전부병례균근거결석부위행간장부분절제술,8례쌍측수루자,행좌반간절제、우간관취석술.술후출현병발증14례(14.3%),위수술기사망2례(2.0%).수방초과1년차미합병종류자78례(79.6%),료효우량솔위91.0%,결석잔존솔화복발솔균위2.0%.결론 간절제술치료기능청제결석,우능절제병변적담도,구유결석잔존솔저화복발솔저적우점,동시능대담도악성종류조진조치,시치료간내담관결석적중요수단.
    Objective To investigate the effect and long-term prognosis of patients who underwent hepatectomy for hepatolithiasis. Methods We retrospectively analyzed the medical records of 98 patients with hepatolithiasis who were treated by hepatectomy in Peking Union Medical College Hospital.Results Male/femah:1/1.7;median age:55 years old.58 cases(59.2%)had been treated before;among them.50 by surgery.In 88 cages(89.8%)hepatolithiasis involved the left lobe only,in 2(2.0%) only the right lobe involved.and in 8(8.2%)both left and right lobe were involved.51(52.0%)had extrahepatic biliary stones,30(30.6%)had biliary duct strictures,28(28.6%)had a history of biliary ascariasis.and 5(5.1%)had a concurrent biliary tract malignancy.All received partial hepatectomy according to the stone location;for the 8 bilaterally involved patients,left hepatectomy and right lithotomy were performed.Postoperative complications occurredin 14 cases(14.3%),and there were2perioperative deaths(2.0%).Seventy-eight patients(79.6%)have beenfollowedupfor over1 yearwith no tumors;the results were excellent or good in 91.0%;the stone residue and recurrence rate were both 2.0%.Conclusions Hepatectomy not only eliminates calcuci,but also removes diseased biliary tracts,with advantages of low residue stone and recurrence rate.
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