Objective To explore the curative effect of precise hepatectomy techniques in hepatolithus. Methods Totally 66 patients undergoing precise hepatectomy and 54 patients receiving irregular hepatectomy were prospectively and non-randomly analyzed,and the intraoperative and postoperative indexes such as operation time, blood loss, postoperative complications, hospital stay, clearance rate of calculus,and recurrence rate of calculus were compared. Results As compared with irregular hepatectomy group, the operation time was prolonged[(264. 6± 55. 3) min vs.(192. 9 ± 48. 7) min,P <0.05], but blood loss, incidence of postoperative complications, recurrence rate of calculus and transfusion number were significantly reduced in precise hepatectomy group(P<0. 05). The postoperative damage to liver function was milder and discovered more quickly, and clearance rate of calculus was higher in precise hepatectomy group than in irregular hepatectomy group(P<0. 05). The total recurrence rate of calculus after operation in precise hepatectomy group was significantly lower than in irregular hepatectomy group. Conclusion Precise hepatectomy was more satisfactory than irregular hepatectomy in the treatment of hepatolithus.%目的 评估精准肝切除在治疗肝胆管结石病中临床疗效.方法 对2年内收治的120例肝内胆管结石病病人,采用前瞻性、非随机对照临床试验方法进行研究；分为精准肝切除66例(精准组)和非规则性肝切除54例(对照组),对比两组在手术时间、术中出血量、术后并发症、住院时间、结石清除率和术后结石复发等方面的差异.结果 精准组手术时间(264.6±55.3) min,长于对照组的(192.9±48.7) min,差异有统计学意义(P＜0.05),其术中出血量、输血例数、术后腹腔流量及术后并发症明显少于对照组(P＜0.05)；与对照组比较,其术后肝功能损害轻、恢复快(P＜0.05),结石清除率更高(92.4％比81.5％,P＜0.05)；同样,精准组病人术后随访结石总复发率(7.5％)明显低于对照组(17.5％).结论 精准肝切除治疗肝胆管结石病临床疗效优于非规则性肝切除术.
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