肝内胆管结石并胆管狭窄的手术治疗63例分析

目的 探讨肝内胆管结石并狭窄的手术治疗方法及其效果。方法 回顾性总结了2002年7月～2004年1月间63例肝内胆管结石并胆管狭窄的外科手术治疗资料。结果 该组63例中行肝叶切除49例，胆总管切开取石 T管引流37例，胆肠吻合 肝叶切除或胆总管取石28例。肝门部肝胆管狭窄整形19例。术后残留结石41例，术后经胆道镜取石32例。有9例术后常有上腹隐痛或发烧。结论 对肝内胆管多发结石，尤其是胆道狭窄病变的患者，应用肝叶切除并内引流术是一种有效的治疗手段。

Surgical treatment of intrahepatic cholelithiasis and biliary stricture

Objective: To investigate surgical measurement and effect of patients with intrahepatic cholelithiasis and biliary stricture. Methods: A clinical retrospective study was made in 63 patients with cholelithiasis and biliary sricture. Results: Among them 49 cases were subjective to hepatectomy, 37 cases to choledochotomy plus T-tube drainage, 28 cases to hepatectomy, cholangiotomy and biliary-enteric anastomosis, 19 cases to plastic operations of the hepatic duct stricture. In 41 cases residual stones were found and the residual stones of 32 cases were removed by fiber biliary endoscopy. After operation 9 cases reported of upper abdominal pain and fever. Conclusions: Patients with hepatolithiasis are complicated with local hepatic atrophy and biliary stricture. Partialhepatectomy ,plastic operation of biliary stricture, combined with biliary-enteric are effective ways to treat hepatolithiasis with biliarystricture.