肝内胆管结石患者肝切除手术的风险
[Surgical risks for patients with hepatolithiasis undergoing hepatectomy].
作者信息
Xu Yong, Ren Zuhai, Zhu Shaihong
机构信息
Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, China.
出版信息
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2012 Sep;37(9):916-9. doi: 10.3969/j.issn.1672-7347.2012.09.010.
OBJECTIVE
To evaluate the risk of hepatectomy by detecting liver functional reserve preoperatively for patients with primary hepatolithiasis.
METHODS
The clinical data of 134 patients with primary hepatolithiasis who underwent hepatectomy were reviewed. In terms of evaluation methods for preoperative liver functional reserve they were divided into a Child-Pugh group (group CP) and an indocyanine green group (group ICG). The preoperative and intraoperative parameters, and the incidence of postoperative complications were analyzed.
RESULTS
Liver failure was more common in group CP (12.85%) than that in group ICG (1.56%, P<0.05). The overall complication rate in group CP (37.14%) was higher than in group ICG (18.75%, P<0.05).
CONCLUSION
ICG15 retention test is more accurate in evaluating liver functional reserve than Child-Pugh scoring system. It may predict the postoperative liver failure in patients with primary hepatolithiasis undergoing hepatectomy, decrease postoperative complications, and increase operation safety.
目的
通过术前检测原发性肝内胆管结石患者的肝功能储备来评估肝切除术的风险。
方法
回顾性分析134例行肝切除术的原发性肝内胆管结石患者的临床资料。根据术前肝功能储备评估方法，将其分为Child-Pugh组（CP组）和吲哚菁绿组（ICG组）。分析术前及术中参数以及术后并发症的发生率。
结果
CP组肝衰竭发生率（12.85%）高于ICG组（1.56%，P<0.05）。CP组总体并发症发生率（37.14%）高于ICG组（18.75%，P<0.05）。
结论
ICG15滞留试验在评估肝功能储备方面比Child-Pugh评分系统更准确。它可能预测原发性肝内胆管结石患者肝切除术后的肝衰竭，减少术后并发症，提高手术安全性。
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