Simi M, Basoli A, Loriga P, Leardi S, Rabuffi F, Antonelli D
Minerva Chir. 1979;34(1-2):105-18.
Out of 2,700 operations for cholelithiasis and its sequelae (1960-1976), 36 cases (1.3%) of intrahepatic lithiasis (i.l.), namely proximal to the origin of the common hepatic, were observed. The prime objective of treatment namely removal of calculi, was achieved indirectly (hepatocholedochus and/or papilla) in 84% of cases, directly (hilar) in 16%. The second objective, that of ensuring optimal bilio-enteric drainage, was achieved by papillostomy or hepaticojejunostomy depending on the lumen of the bile way (respectively less or more than 2 cm.). Operative mortality was nil, while long-term results have proved poor in 9.6% of cases. The i.l. problematic is dealt with in detail on the basis of this series.
在2700例胆结石及其后遗症手术(1960 - 1976年)中,观察到36例(1.3%)肝内结石(i.l.),即位于肝总管起始部近端。治疗的主要目标即清除结石,84%的病例通过间接方式(肝总管和/或乳头)实现,16%通过直接方式(肝门部)实现。第二个目标,即确保最佳胆肠引流,根据胆管腔大小(分别小于或大于2厘米)通过乳头造口术或肝空肠吻合术实现。手术死亡率为零,而长期结果显示9.6%的病例效果不佳。基于该系列对肝内结石问题进行了详细探讨。