Li Shao-qiang, Liang Li-jian, Peng Bao-gang, Li Dong-ming, Lü Ming-de
Department of Hepatobiliary Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
Zhonghua Wai Ke Za Zhi. 2006 Dec 1;44(23):1607-9.
To evaluate the optimal timing of hepatectomy for intrahepatic lithiasis complicated with acute cholangitis.
One hundred and twenty-six patients with hepatolithiasis who had a history of acute cholangitis and underwent hepatectomy were reviewed retrospectively. According to the period between the surgery and last attack of acute cholangitis, 126 patients were divided into 3 groups: > 3 months (group A, n = 73), 1 approximately 3 months (group B, n = 28), < 1 month (group C, n = 25). The operation time, blood loss, hospital stay, postoperative complications and stone residual rate were compared among the groups.
The intraoperative blood loss of C group was (644.0 +/- 625.7) ml, which was significantly higher than those of A and B group [(409.2 +/- 250.7) ml and (423.2 +/- 237.1) ml, respectively]. The numbers of patients who needed transfusion and the amount of blood transfusion in group C were also higher than those of group A and B. The incidence rate of complications, residual stone in group C were all markedly higher than those of group A and B. The period of hospital stay in group C was much longer than that in group A and B.
The optimal timing of hepatectomy for hepatolithiasis complicated with acute cholangitis is at least one month after subsidence of cholangitis.
评估肝内胆管结石合并急性胆管炎患者肝切除术的最佳时机。
回顾性分析126例有急性胆管炎病史并接受肝切除术的肝内胆管结石患者。根据手术与急性胆管炎最后一次发作之间的时间间隔，将126例患者分为3组：>3个月（A组，n = 73），1至3个月（B组，n = 28），<1个月（C组，n = 25）。比较各组的手术时间、失血量、住院时间、术后并发症及结石残留率。
C组术中失血量为（644.0±625.7）ml，显著高于A组和B组[分别为（409.2±250.7）ml和（423.2±237.1）ml]。C组需要输血的患者数量和输血量也高于A组和B组。C组并发症发生率、结石残留率均明显高于A组和B组。C组住院时间比A组和B组长得多。
肝内胆管结石合并急性胆管炎患者肝切除术的最佳时机是胆管炎消退后至少1个月。
