
浏览全部资源
扫码关注微信
400038 重庆,陆军军医大学(第三军医大学)第一附属医院全军肝胆外科研究所
[王曙光,E-mail: sgwangxnyy@sina.com WANG Shuguang, E-mail: sgwangxnyy@sina.com
收稿:2020-09-07,
修回:2020-10-17,
纸质出版:2021-02-15
移动端阅览
陈光宇, 田峰, 何宇, 等. 肝段切除联合体位引流治疗右后下段胆管成角的肝胆管结石[J]. 第三军医大学学报, 2021,43(3):239-243.
Guanyu CHEN, Feng TIAN, Yu HE, et al. Hepatectomy combined with postoperative postural drainage for hepatolithiasis with right posteroinferior bile duct angulation[J]. Journal of Third Military Medical University, 2021, 43(3): 239-243.
陈光宇, 田峰, 何宇, 等. 肝段切除联合体位引流治疗右后下段胆管成角的肝胆管结石[J]. 第三军医大学学报, 2021,43(3):239-243. DOI: 10.16016/j.1000-5404.202009049.
Guanyu CHEN, Feng TIAN, Yu HE, et al. Hepatectomy combined with postoperative postural drainage for hepatolithiasis with right posteroinferior bile duct angulation[J]. Journal of Third Military Medical University, 2021, 43(3): 239-243. DOI: 10.16016/j.1000-5404.202009049.
目的
2
探讨肝段切除联合体位引流在治疗右后下段胆管成角的肝胆管结石中的作用。
方法
2
收集2011年1月至2016年7月在我科收治的右后下段胆管成角的患者165例,按出院后是否行体位引流将纳入患者分为对照组81例(术后未行体位引流)和体位引流组84例(术后坚持行体位引流),分析临床相关数据,比较两组患者术中指标及术后结局、并发症发生率、结石复发率等数据。
结果
2
两组患者术前一般情况、手术并发症等无明显差异,随访期内对照组肝内胆管结石复发率明显高于体位引流组(
P
<
0.001)。对照组急性胆管炎复发率明显高于体位引流组(
P
<
0.001)。对照组的右后下段胆管累积结石复发率明显高于体位引流组(
P
=0.021)。
结论
2
肝段切除联合体位引流能有效降低伴有右后下段胆管成角的肝胆管结石患者术后胆管炎及结石的复发率。
Objective
2
We found that the angle between the right posteroinferior bile duct and the longitudinal axis of the human body was smaller in the patients with stones in the bile duct. This study aimed to reveal the effect of hepatectomy combined with postoperative postural drainage for hepatolithiasis with right posteroinferior bile duct angulation.
Methods
2
All the patients with stones in the right posteroinferior bile duct and the angle mentioned above
<
44.58°admitted into our institute from January 2011 to July 2016 were enrolled in the retrospective study. According to undergoing the postural drainage after surgery or not
they were divided into control group (
n
=81) and drainage group (
n
=84). Clinical data
intraoperative indexes
postoperative outcome
incidence of complications
and recurrence of bile duct stone were analyzed and compared between the 2 groups.
Results
2
There were no significant differences in preoperative general characteristics and surgical complications between the control group and postural drainage group. But the former group had obviously higher stone recurrence rate (
P
<
0.001)
recurrence rate of acute cholangitis (
P
<
0.001)
and cumulative recurrence rates of right posteroinferior bile duct stone (
P
=0.021) when compared with latter group during the follow-up period.
Conclusion
2
Hepatectomy combined with postoperative postural drainage can effectively reduce the recurrence rate of postoperative cholangitis and bile duct stone in patients with hepatolithiasis accompanied by angulation of the right posteroinferior bile duct.
LORIO E, PATEL P, ROSENKRANZ L, et al . Management of hepatolithiasis: Review of the literature[J ] . Curr Gastroenterol Rep, 2020, 22: 1-9. DOI: 10.1007/s11894-020-00765-3
PENG J X, WA NG L Z, DIAO J F, et al . Major hepatectomy for primary hepatolithiasis: a comparative study of laparoscopic versus open treatment[J ] . Surg Endosc, 2018, 32(10): 4271-4276. DOI:10.1007/s00464-018-6176-2.
CHEN G, WU J, XIAO L, et al . Right posteroinferior bile duct angulation correlates with bile duct stone occurrence in patients with hepatolithiasis[J ] . Abdom Radiol (NY), 2020, 45(10): 3103-3108. DOI:10.1007/s00261-020-02444-3.
UCHIYAMA K, KAWAI M, UENO M, et al . Reducing residual and recurrent stones by hepatectomy for hepatolithiasis[J ] . J Gastrointest Surg, 2007, 11(5): 626-630. DOI:10.1007/s11605-006-0024-8.
DEY B, KAUSHAL G, JACOB S E, et al . Pathogenesis and management of hepatolithiasis: a report of two cases[J ] . J Clin Diagn Res, 2016, 10(3): PD11-PD13. DOI: 10.7860/JCDR/2016/16752.7452
STAIN S C, NIGAM A. Management of recurrent cholangitis[M]//Difficult decisions in surgery: An evidence-based approach. Cham: Springer International Publishing, 2016: 227-239. DOI:10.1007/978-3-319-27365-5_20.
RAN X, YIN B, MA B. Four major factors contributing to intrahepatic stones[J]. Gastroenterol Res Pract, 2017, 2017: 7213043. DOI:10.1155/2017/7213043.
0
浏览量
0
下载量
0
CSCD
关联资源
相关文章
相关作者
相关机构
京公网安备11010802024621