基于区段肝蒂的肝切除术在肝胆管结石手术中的应用

发布时间：2018-02-28 13:28

本文关键词： 胆结石胆管肝内肝切除术/方法　出处：《中国普通外科杂志》2017年08期 　论文类型：期刊论文

【摘要】：目的:探讨基于区段肝蒂的肝切除术治疗肝胆管结石的手术效果。方法:采用前瞻性病例对照研究,将90例肝胆管结石患者随机分为研究组和对照组,每组各45例,研究组行基于区段肝蒂的肝切除术,对照组采用B超定位的基于Couinaud肝叶段划分方法的肝切除术,比较两组患者的相关临床指标。结果:两组患者的一般情况、术前肝功能、结石分布、胆管变异和切肝范围均无统计学差异(均P0.05)。研究组较对照组的术中出血量、术后并发症发生率、引流量及术后结石残留率均明显降低(均P0.05),手术时间、输血率、术后肝功能改变、术后排气时间、术后住院时间两组间比较无统计学差异(均P0.05)。结论:基于区段肝蒂的肝切除术具有出血量少,术后渗出及并发症少、结石残留率低等优点,适合在肝胆管结石肝切除手术中应用。
[Abstract]:Objective: to investigate the effect of hepatectomy based on segmental liver pedicle on hepatolithiasis. Methods: 90 patients with hepatolithiasis were randomly divided into study group and control group with 45 cases in each group. The study group received hepatectomy based on segmental liver pedicle, while the control group underwent hepatectomy based on Couinaud segmental segmenting method. Results: the general condition of the two groups, preoperative liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function and liver function were compared between the two groups. There was no significant difference in the distribution of stones, the variation of bile duct and the scope of hepatectomy (all P 0.05). Compared with the control group, the amount of intraoperative bleeding, the incidence of postoperative complications, the drainage flow rate and the residual rate of postoperative stones in the study group were significantly lower than those in the control group (all P 0.05, operation time, blood transfusion rate). There was no significant difference in postoperative liver function change, postoperative exhaust time and postoperative hospitalization time between the two groups (P0.050.Conclusion: the hepatectomy based on segmental liver pedicle has the advantages of less bleeding, less postoperative exudation and complications, low residual stone rate, etc. It is suitable for hepatectomy for hepatolithiasis.
【作者单位】：中山大学附属佛山医院胆道外科;
【基金】：广东省佛山市医学类科技攻关基金资助项目(2014AB00266)
【分类号】：R657.42

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