中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R

留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

规则肝切除术治疗复杂肝内胆管结石的临床体会

吴晓 夏灏 吴健 张明

引用本文:
Citation:

规则肝切除术治疗复杂肝内胆管结石的临床体会

DOI: 10.3969/j.issn.1001-5256.2016.09.025
详细信息
  • 中图分类号: R657.42

Clinical experience in treatment of complex intrahepatic bile duct stones by regular hepatectomy

  • 摘要:

    目的探讨复杂肝内胆管结石行规则肝切除术的临床效果。方法回顾性分析石首市人民医院2013年1-12月98例复杂肝内胆管结石患者的临床资料,分析患者肝内胆管结石分布特点、临床表现、手术范围、手术时间、并发症及手术治疗效果。结果98例患者均完成规则肝切除术,37例行胆总管切开取石T管引流加肝段切除,6例行左肝外叶切除,1例行左半肝切除,7例行右半肝单独肝段及联合肝段切除,45例行左右半肝肝段联合切除,2例行肝门部胆管整形后胆肠盆式吻合。围手术期未出现患者死亡,手术时间(65.0±5.0)min;术中出血量(83.0±6.2)ml,术后无结石残留患者。5例(5.1%)患者出现并发症,其中3例患者并发胆漏,2例患者并发肝脏创面渗血。3例患者术后病理检查发现肝内胆管癌。随访5年,11例(11.2%)患者术后结石复发。结论规则肝切除术治疗复杂肝内胆管结石患者安全且疗效较好,并发症少,结石复发率低,值得临床推广应用。

     

  • [1]SUN Q,CHANG XJ,HU ZM,et al.Laparoscopic anatomical hepatectomy combined with choledochoscopy for hepatolithiasis[J].J Hepatopancreatobiliary Surg,2014,26(6):447-450.(in Chinese)孙强,常晓健,胡泽民,等.腹腔镜下规则性肝切除术联合胆道镜治疗肝内外胆管结石[J].肝胆胰外科杂志,2014,26(6):447-450.
    [2]CHEN YJ,CAI XY,LU BY,et al.Clinical effect of laparoscopic left hepatectomy combined with choledochoscopy in treatment of intrahepatic bile duct stones[J].Guangdong Med J,2014,35(2):241-243.(in Chinese)陈永军,蔡小勇,卢榜裕,等.腹腔镜左肝切除联合胆道镜治疗肝内胆管结石的效果[J].广东医学,2014,35(2):241-243.
    [3]ZHU WD,TAN XG,DENG RG,et al.Clinical application of precise hepatectomy techniques in right intrahepatic bile duct stones[J].Clin J Curr Adv Gen Surg,2013,16(6):451-454.(in Chinese)朱卫东,谭兴国,邓如岗,等.精准肝切除技术在治疗右侧肝胆管结石中的应用[J].中国现代普通外科进展,2013,16(6):451-454.
    [4]ZHUANG ZH,YU XF,ZHENG JF,et al.Outcome of different operative procedures for the intrahepatic lithiasis in 167 cases[J].J Hepatopancreatobiliary Surg,2013,25(2):100-102.(in Chinese)庄哲宏,余小舫,郑锦锋,等.肝内胆管结石167例手术疗效分析[J].肝胆胰外科杂志,2013,25(2):100-102.
    [5]COPELAN A,KAPOOR BS.Choledocholithiasis:diagnosis and management[J].Tech Vasc Interv Radiol,2015,18(4):244-255.
    [6]INOKO K,TSUCHIKAWA T,NOJI T,et al.Hilar cholangiocarcinoma with intratumoral calcification:a case report[J].World J Gastroenterol,2015,21(38):10926-10930.
    [7]CHEN WQ,HE YZ,LI JP,et al.Laparoscopic anatomic left hemihepatectomy plus choledochoscopic lithotomy for concomitant intraand extrahepatic bile duct stones[J].Chin J Gen Surg,2014,23(8):1034-1037.(in Chinese)陈武强,何友钊,李建平,等.腹腔镜规则性左半肝切除联合胆道镜取石治疗肝内外胆管结石[J].中国普通外科杂志,2014,23(8):1034-1037.
    [8]ZHANG XY.The efficacy analysis of anatomical and non-anatomical hepatic lobectomy in 100 patients with hepatolithiasis[J].Chin J Gen Surg,2015,24(7):1050-1053.(in Chinese)张献毅.规则和非规则性肝叶切除术治疗肝胆管结石病患者的效果分析[J].中国普通外科杂志,2015,24(7):1050-1053.
    [9]LU DB,LI QL.Application study of regular hepatectomy with choledochoscope in treatment of intrahepatic bile duct stones[J].J Hanan Med Coll,2016,22(6):562-564,567.(in Chinese)鲁德斌,李乔林.规则性肝切除并胆管镜在肝内胆管结石治疗中的应用研究[J].海南医学院学报,2016,22(6):562-564,567.
    [10]CAO L,LI JW,CHEN J,et al.Analysis of 35 cases of roboticassisted laparoscopic liver resection[J].Pract J Clin Med,2015,12(1):19-21,22.(in Chinese)曹利,李建伟,陈健,等.机器人辅助腹腔镜肝切除35例分析[J].实用医院临床杂志,2015,12(1):19-21,22.
    [11]TANG XD,LIU SH,JIANG J,et al.Different methods of laparoscopic common bile duct exploration for extrahepatic bile duct stones[J].Chin J Hepatobiliary Surg,2013,19(8):589-592.(in Chinese)汤晓东,刘双海,蒋剑,等.不同方式腹腔镜胆道探查术治疗肝外胆管结石的临床研究[J].中华肝胆外科杂志,2013,19(8):589-592.
    [12]LUO KL,FANG Z,YU F,et al.Laparoscopic cholecystectomy and laparoscopic transcystic common bile duct exploration using a mini incision and primary suturing of the bile duct in the treatment of gallbladder and common bile duct stones[J].Chin J Hepatobiliary Surg,2013,19(5):349-351.(in Chinese)罗昆仑,方征,余锋,等.腹腔镜经胆囊管开口微切开胆管并一期缝合胆管治疗胆囊结石合并胆管结石[J].中华肝胆外科杂志,2013,19(5):349-351.
    [13]YANG Q,ZHOU Y,LI FY,et al.Effects of epidermal growth factor receptor inhibitor on proliferative cholangitis in hepatolithiasis[J].Hepatobiliary Pancreat Dis Int,2015,14(5):509-515.
    [14]WANG XP,LUO XR,HUANG HY,et al.Causes of postoperative mental disorders in patients with bile duct stones and related nursing skills[J].J Nurs Training,2013,28(14):1322-1324.(in Chinese)汪小平,罗秀荣,黄海英,等.胆管结石患者术后精神障碍原因分析及护理[J].护士进修杂志,2013,28(14):1322-1324.
    [15]ZHANG R,LUO H,PAN Y,et al.Rate of duodenal-biliary reflux increases in patients with recurrent common bile duct stones:evidence from barium meal examination[J].Gastrointest Endosc,2015,82(4):660-665.
    [16]KONG J,WU SD.Comprehensive review of strategies for diagnosis and treatment of hepatolithiasis[J].J Clin Hepatol,2013,29(3):163-165.(in Chinese)孔静,吴硕东.肝内外胆管结石的综合诊断与治疗[J].临床肝胆病杂志,2013,29(3):163-165.
    [17]CHEN Y,YU XF,BAO SY,et al.MRI to compare the long-term outcomes of partial hepatectomy versus choledocholithotomy in the treatment of hepatolithiasis[J].Chin J Hepatobiliary Surg,2015,21(7):442-444.(in Chinese)陈阳,余小舫,鲍世韵,等.磁共振对比肝切除与胆总管切开取石术治疗肝胆管结石的远期疗效[J].中华肝胆外科杂志,2015,21(7):442-444.
    [18]LYU WP.Clinical classification of hepatolithiasis and choice of surgical strategy[J].J Clin Hepatol,2013,29(6):404-406.(in Chinese)吕文平.肝胆管结石病的临床分型与手术方式选择[J].临床肝胆病杂志,2013,29(6):404-406.
    [19]TEJERA HERNNDEZ AA,CABRERA GARCIA ME,NAVARRO MEDINA P,et al.Hepatolithiasis.Surgical approach using endoscopic holmium laser for treatment[J].Gastroenterol Hepatol,2016.[Epub ahead of print]
    [20]FU N,LUO DY.The application research of the regular hepatectomy treating the complicated intrahepatic cholangiolithiasis[J].J Chengdu Med Coll,2014,9(6):722-724.(in Chinese)付宁,罗道蕴.规则肝切除在复杂肝内胆管结石治疗中的应用研究[J].成都医学院学报,2014,9(6):722-724.
  • 加载中
计量
  • 文章访问数:  2305
  • HTML全文浏览量:  10
  • PDF下载量:  460
  • 被引次数: 0
出版历程
  • 出版日期:  2016-09-20
  • 分享
  • 用微信扫码二维码

    分享至好友和朋友圈

目录

    /

    返回文章
    返回