CAJ | 학술논문

目的探讨肝段(叶)切除胆肠Roux-en-Y吻合加联合抗反流装置治疗肝内胆管结石的治疗效果.方法肝内胆管结石病人230例,其中行肝段(叶)切除联合胆肠Roux-en-Y吻合附加抗反流装置病例103例;行胆总管切开取石、胆总管十二指肠吻合术28例;肝门胆管切开取石、胆管空肠Roux-en-Y吻合术74例;肝总管切开取石、T形管引流术25例.随访时间8～18年.观察手术后近期胸腔积液、切口感染、胆漏、手术后残余结石并发症以及评价远期的治疗效果与结石复发率.结果各组间胸腔积液、切口感染、胆漏并发症比较无显著性差异(P=0.923).与其他组比较,肝段(叶)切除联合胆肠Roux-en-Y吻合附加抗反流装置组的残余结石率显著性降低(P=0.00),一次取净率有显著性增高(P=0.00),治疗效果显著性提高(P=0.00),结石复发率显著性降低(P=0.00).结论肝段(叶)切除胆肠Roux-en-Y吻合加联合抗反流对肝内胆管结石具有良好的治疗效果.
목적 탐토간단(협)절제담장Roux-en-Y문합가연합항반류장치치료간내담관결석적치료효과.방법 간내담관결석병인230례,기중행간단(협)절제연합담장Roux-en-Y문합부가항반류장치병례103례;행담총관절개취석、담총관십이지장문합술28례;간문담관절개취석、담관공장Roux-en-Y문합술74례;간총관절개취석、T형관인류술25례.수방시간8～18년.관찰수술후근기흉강적액、절구감염、담루、수술후잔여결석병발증이급평개원기적치료효과여결석복발솔.결과 각조간흉강적액、절구감염、담루병발증비교무현저성차이(P=0.923).여기타조비교,간단(협)절제연합담장Roux-en-Y문합부가항반류장치조적잔여결석솔현저성강저(P=0.00),일차취정솔유현저성증고(P=0.00),치료효과현저성제고(P=0.00),결석복발솔현저성강저(P=0.00).결론 간단(협)절제담장Roux-en-Y문합가연합항반류대간내담관결석구유량호적치료효과.
Objective To investigate the therapeutic effects of hepatic resection plus Roux-en-Y choledochojejunostomy in combination with reflux prevention on intrahepatie bile duct stone. Methods The clinical data of 230 patients with intrahepaticbile duet stone surgically treated in our hospital in the past 18 years were retrospectively analyzed. Of the 230 patiets, 110 underwent hepatectomy plus Roux-en-Y choledochojejunostgmy in combination with reflux prevention and the others received other surgeries. The complications of pleural effusions, infection of incisional wound, leakage of bile and retained calculus after operation were studied. Meanwhile, the recurrent rate of stone and long-term effects were determined. Results The occurrinjg rate of pleural effusion, infection of incision wound,leakage of bile was not significantly different among different groups. However, the retained calculus and recurrent rate of stone in the group of patients underwent hepateetomy plus Roux-en-Y choledochojejunostomy in combination with reflux prevention were significantly decreased as compared with other group (P<0.05). So was the effect in long-term (P<0.05). Conclusion Hepatectomy plus Roux-en-Y choledochojejunostomy in combination with reflux prevention could have better effect on patients with intrahepatic bile duct stone.