Yamamoto K, Tsuchiya R, Ito T, Harada N, Tsunoda T, Noda T, Izawa K, Miyamoto T
Jpn J Surg. 1982;12(1):6-12. doi: 10.1007/BF02469008.
From 1965 to 1980, reoperations for residual or recurrent stones were performed on 78 out of 962 Japanese patients with cholelithiasis. The majority of patients who required reoperation had intrahepatic stones. Most of the causes of reoperation were residual stones due to incomplete removal or the non-detection of intrahepatic stones at the previous surgery. Very careful examination of the intrahepatic biliary trees should be done in patients with biliary tract diseases, because in many, the first operation was done during their youth. To remove the intrahepatic calculi completely, hepatic lobectomy should be considered as a final procedure. The causes of reoperation of common duct stones were residual in 60 per cent and recurrent in 40 per cent. Definitive surgery should be done at the first or at least the second operation to avoid irreversible hepatic disorders which have untoward effects on the prognosis. It is important not only to remove the stones but also to relieve the bile stasis in the biliary tract.
1965年至1980年期间，962例日本胆石症患者中有78例因残留或复发性结石接受了再次手术。大多数需要再次手术的患者患有肝内结石。再次手术的主要原因是由于上次手术时肝内结石清除不完全或未被发现而残留结石。对于胆道疾病患者，应非常仔细地检查肝内胆管树，因为许多患者的首次手术是在年轻时进行的。为了完全清除肝内结石，肝叶切除术应被视为最终手术方式。胆总管结石再次手术的原因中，残留结石占60%，复发结石占40%。应在首次手术或至少第二次手术时进行确定性手术，以避免对预后产生不良影响的不可逆肝脏疾病。不仅要清除结石，还要解除胆道内的胆汁淤积，这一点很重要。
