Din J, Qureshi A, Daud A, Ahmad H
Department of Surgery, Hospital Universiti Kebangsaan Malaysia, Jalan Tenteram, Cheras, 56000 Kuala Lumpur.
Med J Malaysia. 2000 Dec;55(4):473-7.
Intrahepatic stones remain a major source of morbidity and mortality. With improving techniques in hepatobiliary surgery, the management and the outcome of intrahepatic calculi is reviewed. Forty-nine cases referred from all over Malaysia between January 1993 to June 1996 were analyzed retrospectively. There were thirty-two females and seventeen males. The median age was 46 years. Biliary diseases encountered in association with intrahepatic calculi included benign strictures (n = 14), ascariasis (n = 3), cholangiocarcinoma (n = 1), Caroli's disease (n = 1), and thalassaemia, (n = 1), fifty-six percent of stones were located in both the intrahepatic ducts while 34% were found in the left intrahepatic duct. Thirty-one patients underwent common bile duct exploration either alone or in combination with liver resection or bilioenteric anastomosis. Despite the various combinations of surgical and non-surgical intervention 28 (57.1%) patients had residual stones. Despite the availability of newer techniques in hepatobiliary surgery, residual stones were common, resulting in higher treatment costs.
肝内结石仍然是发病和死亡的主要原因。随着肝胆外科技术的不断进步，对肝内结石的治疗和结果进行了回顾。对1993年1月至1996年6月期间从马来西亚各地转诊的49例病例进行了回顾性分析。其中女性32例，男性17例。中位年龄为46岁。与肝内结石相关的胆道疾病包括良性狭窄（n = 14）、蛔虫病（n = 3）、胆管癌（n = 1）、卡罗里病（n = 1）和地中海贫血（n = 1），56%的结石位于肝内胆管，34%位于左肝内胆管。31例患者单独或联合肝切除术或胆肠吻合术进行了胆总管探查。尽管采取了手术和非手术干预的各种组合，但仍有28例（57.1%）患者残留结石。尽管肝胆外科有了更新的技术，但残留结石仍然很常见，导致治疗成本更高。
