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[肝内胆管结石的肝切除术:20年的演变]

[Liver resection in hepatolithiasis: 20-year's evolution].

作者信息

Huang Zhi-qiang, Huang Xiao-qiang, Zhang Wen-zhi, Xu Li-ning, Yang Tao, Zhang Ai-qun, Dong Jia-hong

机构信息

Institute of Hepatobiliary Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2008 Oct 1;46(19):1450-2.

Abstract

OBJECTIVE

To analyze operative and perioperative factors associated with hepatectomy in hepatolithiasis.

METHODS

245 consecutive hepatolithiasis patients undergoing hepatectomy from January 1986 to December 2005 at Chinese People's Liberation Army General Hospital were investigated retrospectively according to medical documentation.

RESULTS

Hepatolithiasis accounted for 29.6% (245/827) in all benign liver diseases treated with hepatectomy during this time period. There were 88 cases in male and 157 cases in female, the average age was (46.9 +/- 11.3) years. Cases of right liver resection and hepatic segments resection were much more than that in 1963 - 1985. Blood transfusion during operation was given in 45.3% of cases. Complication incidence was 16.3%, with infection 3.3% and bile leakage 2.4%. Length of stay after operation was (15.7 +/- 9.2) days. Perioperative mortality rate was 0.4% (1/245).

CONCLUSIONS

Individualized hepatectomy is the important surgical treatment of hepatolithiasis. Hepatectomy can be performed safely with low mortality and low complication incidence, provided that it is carried out with optimized perioperative management and innovative surgical technique.

摘要

目的

分析肝内胆管结石肝切除术的手术及围手术期相关因素。

方法

回顾性分析1986年1月至2005年12月在中国人民解放军总医院连续接受肝切除术的245例肝内胆管结石患者的病历资料。

结果

在此期间,肝内胆管结石占所有接受肝切除术治疗的良性肝脏疾病的29.6%(245/827)。男性88例,女性157例,平均年龄为(46.9±11.3)岁。右肝切除术和肝段切除术的病例数比1963 - 1985年明显增多。45.3%的病例术中输血。并发症发生率为16.3%,其中感染3.3%,胆漏2.4%。术后住院时间为(15.7±9.2)天。围手术期死亡率为0.4%(1/245)。

结论

个体化肝切除术是肝内胆管结石重要的外科治疗方法。只要采用优化的围手术期管理和创新的手术技术,肝切除术可安全实施,死亡率低,并发症发生率也低。

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