目的：评价肝切除术对肝内胆管结石的治疗效果。方法：回顾性分析我院2007年8月至2012年8月间采用肝切除术治疗46例肝内胆管结石患者的临床资料,统计结石的分布、术式选择、术后并发症及治疗效果。结果：全组46例,行左肝外叶切除34例,左半肝切除6例,右侧肝段(Ⅴ、Ⅵ、Ⅶ、Ⅷ)切除5例,右半肝切除1例。术后残石率为8.7%(4/46例),经 T 管胆道镜及内镜下十二指肠乳头切开术(EST)处理后最终结石残余率2.2%(1/46例)。术后并发症发生率为30.4%(14/46),其中左外叶切除、左半肝切除、右侧肝段切除及半肝切除的手术并发症分别为23.5%(8/34例),33.3%(2/6例),66.7%(4/6例),后两者并发症率高于前者(P<0.05)。结论：肝切除治疗肝内胆管结石，残石率相对较低，结石复发率较低,是比较有效的治疗手段。
Objective:To evaluate the treatment effect of liver resection for hepatolithiasis Methods:The clinical data of 46 cases of hepatolithiasis were retrospectively analyzed from August 2007 to August 2012 .The data included the statistic data of calculus distribution,the choices of operation patterns, the postoperative complications and treatment effects as wel . Results:In the 46 cases, 34 patients were operated on left external lobe .6 patients were treated with left semi hepatectorny,5 patients with right segments (V, VI, VII, VIII) and one patient with right hepatectorny .The percentage of residual stones was 8.7% (4 /46), but there were only 2.2%(1 /46) patients with residual stones after being treated with T-tube choledochofiberscope and EST.On the other hand,there were 30.4% (14/46) patients with related complications .Among the 34 patients ,8(8/34,23.5%)were operated on left external lobe.2(2/6,33.3%)were treated with left semi hepatectorny and 4(4/6,66.7%)were with right semi hepatectorny .The latter two had a higher rate than the former(P<0.05).Conclusion:Liver resection for hepatectony for hepatolithiasis is very effective with advantages of lower rates of residual stones and recurrence.
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