肝内胆管结石57例治疗体会

摘要

Objective To explore treatment rationality and therapeutic effect for intrahepatic bile duct stones. Methods The clinical data of 57 cases of intrahepatic bile duct stones undergoing surgical procedures were retrospectively analyzed in our hospital from November 2006 to August 2010.Results In all these 57 cases of intrahepatic bile duct stones, 33 cases (57. 89 ％) received partial liver resection. Additional T-tube drainage was done in 48 cases (84. 21％). Additional biliary-enteric Roux-en-Y anastomosis was performed on 9 cases (15.79 ％ ). Postoperative residual stones occurred in 7 cases (12. 28 ％). Conclusion Liver resection is the most effective treatment for intrahepatic bile duct stones. By preserving Oddi sphincter function, strictly controlling indications for surgeries of biliary drainage and intraoperative application of cholangioscopy and ultrasound, residuals and postoperative recurrence of intrahepatic bile duct stones could be effectively reduced.%目的 探讨肝内胆管结石治疗方式的合理性及疗效.方法 回顾性分析自2006年11月至2010年8月为57例肝内胆管结石病人手术的临床资料.结果 全部57例中,行肝部分切除33例(57.89%),附加T管引流术48例(84.21%),附加胆肠Roux-en-Y吻合术9例(15.79%).术后复查残留结石7例(12.28%).结论 肝切除是治疗肝内胆管结石的最有效方法,保留Oddi括约肌功能,严格掌握胆肠内引流术的适应证,术中应用胆道镜及B型超声探查,可有效减少肝内胆管结石残留和术后复发.