目的 探讨肝叶切除术治疗肝内外胆管结石的疗效.方法 对44例肝内结石患者采取肝叶切除术+胆总管切开取石+T管引流术,另选取同期肝内结石患者40例采取单纯胆总管取石+T管引流术,比较两组的优良率、术中情况和术后情况等.结果 肝叶切除组近期疗效优良率86.36％,显著优于单纯胆总管切开取石组(67.5％)(P＜0.05);肝叶切除组在手术时间(243.5±74.28) min、住院时间(14.75±2.41)d及术中出血量(251.3±87.21) ml等方面均次于单纯胆总管切开取石组,差异有显著性(P＜0.05),但在远期疗效包括残石率(42.5％)、感染率(30％)和再手术率(2.5％)等方面有显著优势,差异有显著性(P＜0.05).结论 肝叶切除术是治疗肝内胆管结石的根治性术式,远期疗效明显优于单纯胆总管切开取石术.%Objective To discuss the surgical efficacy of liver lobes resection in patients with intra and extrahepatic bile duct stones.Methods 44 patients with hepatolithiasis were performed by the section of common bile duct and calculus remove,liver resection and drainage with T-tube,meanwhile,the procedure was performed for another 41 cases of hepatolithiasis with the section of common bile duct,calculus remove and drainage with T-tube.The efficacy,intraoperative and postoperative situation were compared between two groups.Results The rate of fine postoperative result in shortterm in the liver resection group was 86.36％,better than another group(67.5％) (P＜ 0.05).The liver resection group was significantly fewer than the common bile duct and calculus remove group in the operative time (243.5 ± 74.28)minutes,hospitalization stay (14.75 ± 2.41) days and intraoperative blood loss (251.3 ± 87.21) ml (P＜ 0.05),but it was significantly better than the second group in the rate of residual calculus(42.5％),cholangitis(30％),and second operation(2.5％) (P ＜ 0.05).Conclusion Liver lobes resection is a radical procedure for patients with hepatolithiasis,and the curative effect in long-term was better than common bile duct and calculus remove.
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