复杂性肝胆管结石及狭窄的外科手术60例分析(1)
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[摘要] 目的 分析总结我院普外科治疗的60例复杂性肝胆管结石及狭窄的疾病特点及外科手术治疗方式。 方法 随机将我院普外科2010～2011年手术治疗的60例复杂性肝胆管结石及狭窄的患者分为两组，A组手术方式为肝叶或肝段切除，B组手术方式选择非肝叶或肝段的切除,对比两组患者在手术疗效、术后并发症、术后残石及术后随访复发方面的差异。 结果 ① A组患者的治疗效果明显优于B组,差异具有统计学意义(P<0.05)。②A组的术后残石发生率和复发率均明显小于B组，差异具有统计学(P<0.05)。 ③两组患者在术后并发症方面无统计学差异(P>0.05)。 结论 临床复杂性肝胆管结石及狭窄的外科手术方式的选择很重要，肝叶或肝段切除的方式相对有着明显的优势，可以积极地应用于实践。
[关键词] 复杂性肝胆管结石并狭窄；外科手术治疗
[中图分类号] R657.3 [文献标识码] B [文章编号] 1673-9701(2012)01-136-02
Complexity bile duct stones and stenosis surgery :an analysis of 60 cases
LI Jiabin
Department of General Surgery, the Fourth People's Hospital of Changde City in Hunan Province, Changde 415000, China
[Abstract] Objective To analyse and summarize the disease characteristics and surgical treatment of 60 patients with complicated bile duct stones and stenosis，who are accepted by general department in our hospital. Methods Sixty patients in our hospital general surgery for surgery treatment from 2010 to 2011 were divided into two groups randomly, Group A received resection of hepatic or liver, group B received the resection of non-hepatic or non-liver , Compared the difference of two groups of patients with Curative effect, postoperative complications,，postoperative residual stone and recurrence rate. Results ①The group A patients had better Curative effect than group B，the difference is significant (P<0.05); ②The postoperative recurrence rate and Residual stones rate of group A was significantly less than group B (P<0.05). ③The postoperative complications rate had no significant difference (P>0.05). Conclusion The choice of surgical approach selection for complicated bile duct stones and stenosis patients is important ，resection of hepatic or liver has significant advantages，should be actively used in practice.
[Key words] Complexity of bile duct stones and stenosis surgery;Surgical treatment
肝内胆管结石是胆道系统的最常见的疾病，常常合并有肝胆管的狭窄，所谓复杂性肝胆管结石即同时出现以下四种情况的任意两种[1]：①既往有过至少一次胆道手术；②二级以上肝内胆管弥漫性结石；③伴有胆管狭窄或局部肝萎缩；④伴有肝硬化、门脉高压征、重症胆管炎或肝脓肿等肝内炎性病灶者。笔者参与我院普外科2010~2011年间手术治疗的60例复杂性肝胆管结石及狭窄的患者的治疗，现报道如下。
1 资料与方法
1.1一般资料
选取我院普外科2010～2011年手术治疗的复杂性肝胆管结石及狭窄60例患者为研究对象 ......
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