CAJ | 학술논문

目的探讨精准肝切除联合电子胆道镜在肝胆管结石治疗中的应用价值.方法回顾性分析2012年1月至2014年5月66例肝胆管结石患者的资料,术前利用可视化三维重建进行精确评估,采用精准肝切除联合电子胆道镜技术祛除病灶.结果全部患者手术均成功完成,三维重建对胆管、结石及周围重要血管的解剖学评估结果与术中所见大致相符,术前预切除肝脏体积与术中实际切除肝脏体积呈正相关(r =0.945,P＜0.05).平均手术时间(221±65) min,平均出血量(267±78) ml.术后并发症8例(12％).随访时间为6～30个月,疗效优良,随访发现残留结石5例(8％),2例(3％)复发.结论精准肝切除联合电子胆道镜的应用是治疗肝胆管结石有效、安全、微创的方法,具有较好的临床应用价值.
목적 탐토정준간절제연합전자담도경재간담관결석치료중적응용개치.방법 회고성분석2012년1월지2014년5월66례간담관결석환자적자료,술전이용가시화삼유중건진행정학평고,채용정준간절제연합전자담도경기술거제병조.결과 전부환자수술균성공완성,삼유중건대담관、결석급주위중요혈관적해부학평고결과여술중소견대치상부,술전예절제간장체적여술중실제절제간장체적정정상관(r =0.945,P＜0.05).평균수술시간(221±65) min,평균출혈량(267±78) ml.술후병발증8례(12％).수방시간위6～30개월,료효우량,수방발현잔류결석5례(8％),2례(3％)복발.결론 정준간절제연합전자담도경적응용시치료간담관결석유효、안전、미창적방법,구유교호적림상응용개치.
Objective To investigate the clinical value of precise hepatectomy combined with electronic choledochoscope in the treatment of hepatolithiasis.Method Clinical data of 66 patients with hepatolithiasis from January 2012 to May 2014 were retrospectively analyzed.The preoperative accurate evaluation was achieved by using 3D reconstruction,and the precise hepatectomy combined with cholangioscopy removed the hepatic lesions.Result Operations were successfully completed in all patients.The anatomic evaluation results of visualization of 3D reconstruction on biliary duct,stone and vascular and surgical findings were broadly consistent.The liver volumes of pre resection and actual resection were positively correlated (r =0.945,P ＜ 0.05).The average operation time was (221 ± 65) min,the average amount of bleeding was (267 ± 78) ml.Postoperative complications occurred in 8 cases (12％).Patients were followed up from 3 to 20 months;Residual stones were found in 5 cases (8％),2 cases suffered from stone recurrence (3％).Conclusions Precise liver resection combined with electronic choledochoscope in the treatment of hepatolithiasis is an effective,safe,minimally traumatic therapy.