中国实用外科杂志

中国实用外科杂志

• 论著 • 上一篇    下一篇

第二肝门附近肝实质切开取石术治疗复杂性肝胆管结石13例疗效分析

李恩亮，邬林泉，殷香保，周    凡，罗志强，邵江华   

  1. 南昌大学第二附属医院肝胆外科，江西南昌330006
  • 出版日期:2015-06-01 发布日期:2015-05-29

  • Online:2015-06-01 Published:2015-05-29

摘要：

目的    探讨第二肝门附近肝实质切开取石术治疗复杂性肝胆管结石的临床意义。方法    回顾性分析南昌大学第二附属医院2009年1月至2013年12月收治的13例复杂性肝胆管结石病人的病例资料。手术方法为第二肝门附近肝实质切开取石术，部分病人联合肝部分切除术。结石主要位于肝脏Ⅱ、Ⅳ、Ⅷ段。结果  住院期间病人死亡1例，其他病人均康复出院。11例病人随访至今，1例结石残留，2例复发，其他病例应用B超或CT检查未见胆管炎及结石复发迹象。结论    对于结石主要位于肝脏Ⅱ、Ⅳ、Ⅷ段，伴有病变周边部位肝脏代偿性肥大，无法耐受多肝段切除的病人，第二肝门附近肝实质切开取石术具有较好的疗效。

关键词: 第二肝门, 肝实质切开, 肝胆管结石

Abstract:

Near the second porta hepatic parenchyma lithotomy in the treatment of complicated bile duct stones：A analysis of 13 cases        LI En-liang，WU Lin-quan，YIN Xiang-bao，et al. Department of Hepatobiliary Surgery，the Second Affiliated Hospital of Nanchang University, Nanchang330006，China
Corresponding author：WU Lin-quan, E-mail：Wulqnc@163.com
Abstract    Objective    To investigate the clinical significance of near the second porta hepatic parenchyma lithotomy in the treatment of complicated bile duct stones. Methods    The clinical data of 13 cases of complex hepatolithiasis admitted from January 2009 to December 2013 in the Second Affiliated Hospital of Nanchang University were analyzed retrospectively. Surgical methods were hepatic parenchyma incision lithotomy near the second hepatic portal, or combined partial hepatectomy. Thirteen cases include 6 males and 7 females. Stones are mainly located in section Ⅱ, Ⅳ, Ⅷ section. Results    One case died during hospitalization and the other cases were recovered and discharged. A total of 11 cases were followed up to now, during which residual calculi happened in 1 case, recurrent hepatolithiasis in 2 cases, and other cases showed no signs of recurrent calculus and cholangitis through using ultrasound or CT examination. Conclusion Hepatic parenchyma incision lithotomy near the second hepatic portal used to treat those cases whose stones mainly located inⅡ, Ⅳ and Ⅷ segments accompanied by partial liver compensatory hypertrophy around the lesions and those cases who cannot tolerate multiple hepatic segment resection has a better effect.

Key words: second hepatic portal, liver parenchyma lithotomy, hepatolithus