大口径肝门胆肠内引流术治疗肝内胆管结石的体会

摘要

Objective： To explore effective surgical Procedure in treating hepatolithiasis.Method： From1993 through 2000,15 cases of hepatolithiasis were treated with large caliber cholangio-enterostomy at the hepatic hilum.All of 15 cases had multiple intrahepatic stones, which mainly occurred in gradeone or two intrahepatic ducts.During operation,the common and grade one to two intrahepatic biliaryducts with structures were incised,and were anastomosed widely to the jejunum with single large eversion suture according to the Roux-en-Ytechnique.During operation,intrahepatic stones were cleared up with the help of fibro-oplic-cholangioscope.Results:The result after follow-upof 6 to 60 months revealed that 15 cases had anamelioration of symptoms affer operation.Conclusion:It is suggested that large caliber cholangio-enterostomy at the hepatic hilum is one of idealoperations in treating hepatolithasis.%目的：为了探讨治疗肝内胆管结石的有效手术方法。方法：在1993～2000年我们对15例肝内胆管结石的病例施行大口径肝门胆肠内引流术，15例均为肝内胆管多发结石，狭窄好发于邻近肝门的1～2级肝内胆管开口，手术中充分切开肝门部的肝外胆管和1～2级肝内胆管分枝及其狭窄部，术中借助胆道镜检查及取石，并与空肠行一层外翻大口Rous－en－Y型吻合。结果：经6～60个月的随访表明，15例(100%)疗效优良。结论：大口径肝门胆肠内引流术是一种治疗肝内胆管结石较理想的术式。