关键词: 肝内胆管结石, 肝叶切除加“, T”, 管引流术, 胆总管空肠Roux-en-Y吻合术, 疗效

Abstract: Objective To compare the clinical effect of hepatic lobe resection with“T” tube drainage and bile duct-jejunum Roux en-Y anastomosis in the treatment of patients with intrahepatic bile duct calculi. Methods From January 2011 to January 2015,80 cases of intrahepatic biliary calculi patients were randomly divided into hepatic lobe resection with “T” tube drainage group（n=39）,and common bile duct-jejunum Roux en-Y anastomosis group （n=41）. Results The early postoperative residual stones was 7 （18.0%）,infection of incision 4 （10.3%）,abdominal cavity infection 6（15.4%）,bile leakage 4（10.3%） in hepatic lobe resection,while they were 8（19.5%,P>0.05）,5（12.2%,P>0.05）,6（14.6%,P>0.05）,and 4（9.8%,P>0.05）;the postoperative residual cholangitis （8.3%）,stone with bile duct calculi recurrence（4.2%）,anastomotic stenosis（4.2%） in patients receiving hepatic lobe resection were significantly lower than in bile duct-jejunum Roux en-Y anastomosis group（24.4%,19.5%,7.3% and 22.0%,respectively,P<0.05）;the serum bilirubin levels in hepatic lobe resection group were（10.87±2.36） μmol/l, ALT were（38.96±10.28） U/L,AST were（34.76±5.47） U/L and ALP were（108.04±23.40） U/L, significantly lower than in bile duct-jejunum Roux en-Y anastomosis group （[（18.96±2.01） μmol/l,（76.83±15.67） U/L,（45.54±4.58） U/L and（176.42±34.58） U/L,respectively,P<0.05]. Conclusion Hepatic lobe resection with “T” tube drainage in the treatment of patients with intrahepatic bile duct stones is effective with lower incidence of complications and improved liver function.

Key words: Intrahepatic bile duct stones, Lobe resection with“T”, tube drainage, Anastomosis of common bile duct jejunum Roux en-Y, Efficacy