保留胆囊对肝内外胆管结石术后复发的影响

doi:10.3969/j.issn.1009-976X.2018.04.007

岭南现代临床外科 ›› 2018, Vol. 18 ›› Issue (04): 397-399.DOI: 10.3969/j.issn.1009-976X.2018.04.007

保留胆囊对肝内外胆管结石术后复发的影响

吴志扬1，李刚1，陈明1，刘京山2，杨玉龙3，卢德光1，陈向清1，谢维捷1，曾锦涛1

1. 肇庆市中医院普外科，广东肇庆526020； 2. 北京大学首钢医院普外科，北京100144； 3. 大连大学附属中山医院肝胆外科、胆道微创外科，辽宁大连116001

通讯作者: 吴志扬

Effect of gallbladder retention on postoperative recurrence of intrahepatic and extrahepatic cholelithiasis

WU Zhiyang1， LI Gang1， CHEN Ming1， LIU Jingshan2， YANG Yulong3， LU Deguang1， CHEN Xiangqing1，XIE Weijie1，ZENG Jintao1

1. Zhaoqing Hospital of Traditional Chinese Medicine，Zhaoqing，Guangdong 526020，China； 2. The Affiliated Shougang Hospital of Peking University，Beijing，100144，China； 3. the Affiliated Zhongshan Hospital Dalian University；Dalian，Liaoning 116001，China

Online:2018-08-20 Published:2018-08-20
Contact: WU Zhi-Yang

摘要/Abstract

摘要： ［摘要］目的通过对接受对肝内、外胆管结石患者术中保留胆囊，观察保留胆囊后胆管结石远期复发情况并进行评价。方法共59 例纳入研究，其中有37 例胆总管结石合并或不合并胆囊结石病人行保留胆囊（保胆术）的胆总管切开取石术；22 例肝内胆管结石合并或不合并胆囊结石，行保留胆囊的取石手术（包括肝部分切除、胆总管切开胆道镜取石），远期随访观察两组病例复发率。结果保留胆囊的胆总管结石 3 年复发率为 2.7% ；保留胆囊的肝内胆管结石 3 年复发率4.54%，与文献相比复发率低，但保留胆囊的肝外胆管结石术后结石复发率与文献报道的差异没有统计意义。结论保留胆囊没有增加肝内、外胆管结石的复发，胆囊功能的保留有助于胆道系统的完整性，这可能有利于减少肝内、外胆管结石术后的复发。

关键词: 肝内、外胆管结石术后复发, 保留胆囊

Abstract: ［Abstract］ Objective To observe the preservation of gallbladder in patients with intrahepatic andextrahepatic cholelithiasis by comparing with the traditional method of cholecystectomy. Methods Thirty? seven patients with choledocholithiasis or with cholecystolithiasis were treated with choledocholithiasis and22 patients with intrahepatic cholelithiasis or cholelithiasis were treated with choledocholithotomy. Cholecystolithotomy （including partial hepatectomy）. Results The recurrence rate of intrahepatic choledocholithiasis was 4.54% and the recurrence rate of cholecystic choledocholithiasis was 2.7%，which was significantly lower than that of the literature. Conclusion The strategy of preserving the gallbladder in intrahepatic and extrahepatic calculi surgery does not increase the recurrence of intrahepatic and extrahepatic bile duct stones. The preservation of gallbladder function contributes to the integrity of the biliary system and may reduce the chance of recurrence of intrahepatic and extrabiliary calculi.

Key words: retention of gallbladder, recurrence of hepatolithiasis after intrahepatic and choledocholithiasis

吴志扬1，李刚1，陈明1，刘京山2，杨玉龙3，卢德光1，陈向清1，谢维捷1，曾锦涛1. 保留胆囊对肝内外胆管结石术后复发的影响[J]. 岭南现代临床外科, 2018, 18(04): 397-399.

WU Zhiyang1， LI Gang1， CHEN Ming1， LIU Jingshan2， YANG Yulong3， LU Deguang1， CHEN Xiangqing1，XIE Weijie1，ZENG Jintao1. Effect of gallbladder retention on postoperative recurrence of intrahepatic and extrahepatic cholelithiasis[J]. Lingnan Modern Clinics in Surgery, 2018, 18(04): 397-399.

保留胆囊对肝内外胆管结石术后复发的影响

Effect of gallbladder retention on postoperative recurrence of intrahepatic and extrahepatic cholelithiasis

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