中国实用外科杂志

中国实用外科杂志 ›› 2009, Vol. 29 ›› Issue (07): 571-573.

• 论著 • 上一篇    下一篇

限量肝切除加球囊扩张治疗复杂性肝胆管结石并狭窄疗效分析

田伏洲，骆助林，汤礼军，汪 涛，任建东，闫 勇   

  1. 成都军区总医院全军普通外科中心，四川成都610083
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2009-07-08 发布日期:2009-07-08

  • Received:1900-01-01 Revised:1900-01-01 Online:2009-07-08 Published:2009-07-08

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摘要：

目的 探讨复杂性肝胆管结石并狭窄的有效治疗方法。方法 在成都军区总医院2002年3月至2008年3月收治的复杂肝胆管结石并狭窄76例病人中，选择出34例分为传统手术组和球囊扩张组（各17例），男16例，女18例。平均年龄为46（27~65）岁。分别进行传统手术方法和球囊渐进扩张法治疗复杂肝胆管结石并狭窄，术后长期随访观察。结果 34例病人均完成手术，术后随访1～7年，平均2.8年。传统手术组治愈12例，好转2例，加重1例，死亡2例，其中出现并发症5例；球囊扩张组治愈10例，好转7例，出现并发症1例，无加重或死亡病例。结论 限量肝切除可以减少肝切除术给病人带来的直接损伤和危险，而球囊渐进扩张分期取石是除肝切除和肝门整形以外，另一种治疗复杂肝胆管结石并狭窄的较为安全可靠的方法。

关键词: 复杂肝胆管结石, 胆管狭窄, 胆道球囊扩张, 限量肝切除

Abstract:

Treatment of complicated intrahepatic stones accompanied with biliary stricture by limited hepatectomy and balloon dilatation TIAN Fu-zhou, LUO Zhu-lin, TANG Li-jun, et al. PLA General Surgery Center,Chengdu General Military Hospital,Chengdu 610083,China. Corresponding author: TIAN Fu-zhou, E-mail：tfz30061@yahoo.com.cn Abstract Objective To summarize the treatment experience of the patients suffered the complicated intrahepatic stones accompanied with biliary stricture in our hospital in the recent 6 years. Methods From 76 patients with complicated intrahepatic stones accompanied with biliary stricture between march, 2002 and march, 2008, 34 patients (male 16 and female 18), of mean age 46 (range 27~65) years, were selected and divided equally into two groups which underwent traditional surgery and progressive balloon dilatation, respectively. The follow-up was carried out after the treatment. Results After the follow-up of mean 2.8 (range 1~7) years, 12 cases were cured, 2 were improved, 1 was aggravated and 2 were dead in the traditional surgery group. In contrast, 10 cases were cured, 7 got improvements, and only 1 had complications. There were no aggravated or dead case in this group. Conclusion the risk of trauma in surgery can be diminished by limited hepatectomy.the treatment of progressive balloon dilatation,as well as hepatectomy and hepatic portal plasty, exhibit good safety and efficiency in the treatment of complicated intrahepatic stones accompanied with biliary stricture.

Key words: complicated intrahepatic stones, biliary stricture, biliary balloon dilatation, limited hepatectomy