Caudate lobe-sparing subtotal hepatectomy for primary hepatolithiasis
Caudate lobe-sparing subtotal hepatectomy for primary hepatolithiasis
复制标题
保留尾状叶肝次全切除术治疗原发性肝结石
DOI：
10.1002/bjs.8888
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发表时间：
2012-10-01
影响因子：
9.6
通讯作者：
Ji, W.
中科院分区：
文献类型：
--
作者：
Dong, J.;Lau, W. Y.;Ji, W.
背景资料：对因双侧原发性肝内胆管结石伴主肝萎缩和尾状叶巨大肥大而频繁发作并危及生命的胆管炎患者进行保留尾状叶的肝次全切除术。研究方法：这是一项回顾性研究，前瞻性收集了2003年3月至2009年12月期间接受保留尾状叶次全肝切除术（切除7个肝段，仅留下尾状叶）的患者的数据。所有患者均行胆道探查和胆道镜检查。分析围手术期和长期结局。结果：所有12例患者均获得了即刻结石清除。2例患者行尾状胆管狭窄成形术。没有住院死亡，三名患者出现了六种并发症。在平均51个月的随访中，1名患者在8个月时尾状叶胆管中出现复发性结石，并在术后17个月死于急性化脓性胆管炎。其余11例患者无胆道梗阻，无进一步急性胆管炎发作。结论：保留尾状叶的肝次全切除术是治疗双侧原发性肝内胆管结石的一种安全有效的方法。版权所有（c）2012英国外科学会杂志有限公司由约翰威利父子有限公司出版。
Background: Patients with frequent and life-threatening attacks of cholangitis due to bilateral primary hepatolithiasis with atrophy of the main liver and giant hypertrophy of the caudate lobe were assessed for caudate lobe-sparing subtotal hepatectomy. Methods: This was a retrospective study of prospectively collected data from patients who underwent subtotal hepatectomy with sparing of the caudate lobe (resection of 7 liver segments, leaving only the caudate lobe) between March 2003 and December 2009. All patients had concomitant bile duct exploration and choledochoscopy. Perioperative and long-term outcomes were analysed. Results: Immediate stone clearance was obtained in all 12 patients enrolled in the study. Two patients had strictureplasty of the strictured caudate bile duct. There was no hospital mortality and six complications developed in three patients. At a mean follow-up of 51 months, one patient had developed recurrent stones in the caudate lobe bile ducts at 8 months and died from acute purulent cholangitis, 17 months after surgery. The remaining 11 patients were symptom-free with no further attacks of acute cholangitis. Conclusion: In selected patients with bilateral primary hepatolithiasis, caudate lobe-sparing subtotal hepatectomy is a safe and effective treatment. Copyright (c) 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.