罗昆仑 1方征 1余锋 1刘洪 1田志强 1董志涛1
作者信息
- 1. 解放军第一○一医院肝胆外科,江苏无锡214044
- 折叠
摘要
Abstract
Objective: To evaluate the efficacy of multiple hepatic segmentectomies for complex hepatolithiasis. Methods: The clinical data of 93 patients with hepatolithiasis who underwent multiple liver segmentectomies were retrospectively analyzed. The procedures included 5 cases of right lobectomy, 7 cases of right posterior lobectomy, 2 cases of right posterior lobe plus left lateral lobe resection, 1 case of segment VIII plus caudate lobectomy, 3 cases of segment VIII and left lateral lobe resection, 2 case of subtotal segment VII and VIII plus left lateral lobe resection, 5 cases of right anterior lobectomy, 2 cases of segment IV and V resection, 5 cases of segment IV, V and VIII resection, 19 cases of left lobectomy, 4 cases of left and caudate lobectomy, 6 cases of segment IV resection, and 32 cases of left lateral lobectomy. Additional choledochojejunostomy was performed in 22 cases. All the patients underwent cholecystectomy, cholangioscopic exploration and/or stone extraction, and common bile duct T-tube drainage. Results: There was no operative mortality. Postoperative complications occurred in 17 cases (18.2%),including 2 cases of bile leakage (2.2%), 1 case of subphrenic infection (1.1%), 6 cases of wound infection (6.4%), 3 cases of pulmonary infection (3.2%), 6 cases of pleural effusion (6.4%), and 2 cases of stress ulcer (2.2%). All of these complications resolved before the patients were discharged. In 9 cases, residual stones were found after operation and they were completely removed by cholangioscopy in 5 of them. Follow-up was obtained in 89 cases (95.7% of the whole group), of whom 3 cases with concomitant cholangiocarcinoma died of tumor recurrence and 3 cases developed bile duct stone recurrence.Conclusion: Multi-segmentectomies as the main operation modality is effective in the treatment of complex hepatolithiasis.关键词
胆结石/外科学/肝切除术/方法/胆管,肝内Key words
Cholelithiasis/surg/ Hepatectomy/methods/ Bile Ducts, Intrahepatic分类
医药卫生
