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肝胆管结石初始外科治疗的规范化研究
More attention to initial surgical treatment of hepatolithiasis
文章发布日期:2015年09月06日  来源:  作者:李江,刘斌  点击次数:2256次  下载次数:447次

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【摘要】:肝胆管结石是我国西南地区最常见的良性胆道疾病之一,外科手术是该病最佳的治疗方式。但由于该病起病隐匿,病程复杂多样,术后结石残留、复发率及胆管癌变率高,而且相当一部分患者因为初始治疗决策不当,导致反复多次手术,使病情更加复杂,治疗更加困难。因此,初始外科治疗是否得当,将明显影响肝胆管结石的近远期疗效。对于初始治疗的患者,务求详细而全面的诊断和充分的评估病情,制订规范且个体化的治疗方案,选择合适的手术时机,尽量采用以肝段或肝叶切除为基础的手术方案,合理使用胆道镜、术中B超等辅助设备,力求达到彻底去除病灶,防止复发以及降低再手术率的治疗目的。
【Abstract】:Hepatolithiasis is one of the most prevalent benign biliary tract diseases in Southwest China, and surgery is the optimal treatment for this disease. However, hepatolithiasis has insidious onset and complicated course, as well as high rate of residual stones and recurrence and high incidence of cholangiocarcinoma after operation, and some patients undergo surgery several times due to inappropriate initial therapeutic strategy, resulting in more severe condition and more difficult treatment. Therefore, initial surgical treatment is the key to the short-term and long-term outcomes of hepatolithiasis. For previously untreated patients, comprehensive diagnosis and adequate disease assessment, standardized and individualized therapeutic strategy, and appropriate operation time are warranted, the procedures based on hepatic segments and hepatic lobes are preferred, and the choledochoscope and B-mode ultrasound should be properly used during the operation, so as to resect the lesions, prevent recurrence, and reduce the reoperation rate.
【关键字】:胆结石;胆道外科手术;肝切除
【Key words】:cholelithiasis; surgical procedures; hepatectomy
【引证本文】:李江, 刘斌. 重视肝胆管结石的初始外科治疗[J]. 临床肝胆病杂志, 2015, 31(10): 1612-1614.

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