肝部分切除联合胆肠吻合术治疗肝内胆管结石患者疗效比较研究*

doi:10.3969/j.issn.1672-5069.2022.01.028

Abstract

Abstract: Objective The aim of this study was to observe the clinical efficacy of partial hepatectomy and choledochojejunostomy in treatment of patients with hepatolithiasis. Methods 68 patients with hepatolithiasis were admitted to our hospital between February 2017 and February 2020, and 38 patients in the observation group underwent partial hepatectomy and choledochojejunostomy., and 30 cases in the control underwent partial hepatectomy only. All patients were followed-up for 12 months after surgery. Serum interleukin-6 (IL-6) and C-reactive protein (CRP) were detected by ELISA or by double-antibody sandwich immunoluminescence method. Results The operation time, intraoperative blood loss and hospitalization stay in observation group were(106.7±29.8)min,(261.7±64.2)mL and (15.5±3.5)d, significantly longer or greater than [(64.3±27.7)min,(190.3±49.0)mL and (10.2±2.3)d, respectively, P＜0.05] in the control; seven days after operation, serum CRP and IL-6 levels in the observation group were (38.0±5.9)mg/L and (99.6±10.7)μg/L, significantly higher than [(25.2±5.1)mg/L and (83.6±9.8)μg/L, respectively, P＜0.05] in the control; there were no significant differences respect to serum hepatic function tests before and after operation between the two groups (P>0.05); at the end of three month followed-up, the incidences of incisional infection, bile leak, biliary bleeding and pleural-peritoneal effusion in the two groups were not significantly different (13.2% vs. 13.3%, P＞0.05); the sonography check-up six weeks after surgery showed that the stone residual rate in the observation group was 5.3% (2/38), significantly lower than 23.3% (7/30, P<0.05) in the control, and at the end of 12-month followed-up, the stone recurrence in the observation group was 13.2%, significantly lower than 33.3%(P＜0.05) in the control. Conclusion The application of partial hepatectomy and choledochojejunostomy in the treatment of patients with hepatolithiasis might reduce stone residuals and recurrence, and needs to be further verified.

Key words: Hepatolithiasis, Partial hepatectomy, Choledochojejunostomy, Surgery

Duan Changhu, Liu Xiaochen, Duan Jianfeng. Clinical observation of partial hepatectomy and choledochojejunostomy in treatment of patients with hepatolithiasis[J]. Journal of Practical Hepatology, 2022, 25(1): 112-115.

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Clinical observation of partial hepatectomy and choledochojejunostomy in treatment of patients with hepatolithiasis

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