摘要
目的探讨肝左外叶切除联合胆道镜取石治疗左肝内胆管结石的临床疗效。方法回顾性分析我院2013年1月～2017年1月收治的42例左肝内胆管结石患者的临床资料,并按手术方式的不同将他们分为实验组和对照组(各21例),实验组和对照组患者分别采用肝左外叶切除联合胆道镜取石和左半肝切除治疗左肝内胆管结石。分析比较两组患者手术时间、术中出血量、近期疗效和术后并发症。结果实验组和对照组手术时间分别为180. 21±37. 16 min和232. 16±39. 25min,术中出血量分别为360. 12±163. 24 ml和521. 36±199. 27 ml,总并发症发生率分别为14. 29%和28. 57%,差异均有统计学意义。实验组和对照组术后残石率分别为4. 76%和0,有效率分别为90. 48%和85. 71%,差异无统计学意义。结论肝左外叶切除联合胆道镜取石治疗左肝内胆管结石可缩短手术时间、减少术中出血量和并发症的发生。
Objective To investigate the clinical effect of left hepatic lobectomy combined with choledochoscopy in the treatment of left hepatic intrahepatic bile duct stones. Methods The clinical data of 42 patients with left intrahepatic bile duct stones treated in our hospital from January 2013 to January 2017 were retrospectively analyzed. The patients were divided into experimental and control group(21 cases each) according to the different surgical methods. The left lateral lobe resection combined with choledochoscopy and left hemihepatic resection were used to treat the left hepatic bile duct stones in the experimental and control group,respectively.The operation time,intraoperative blood loss,short-term curative effect and postoperative complications were analyzed and compared between the two groups. Results The operation time in the experimental and the control group were 180. 21 ± 37. 16 min and 232. 16± 39. 25 min respectively. The intraoperative blood loss in the experimental and the control group were 360. 12 ± 163. 24 ml and521. 36 ± 199. 27 ml respectively. The total complication rates in the experimental and the control group were 14. 29% and 28. 57% respectively. The above three indicators were statistically significant differences. The postoperative residual stone rate in the experimental group and the control group were 4. 76% and 0 respectively,and the effective rates were 90. 48% and 85. 71% respectively. There was no statistically significant difference between the two indicators above. Conclusion Left hepatic lobectomy combined with choledochoscopy can shorten the operation time as well as reduce the amount of intraoperative blood loss and complication.
引文
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