Surgical Treatment of the Intrahepatic Lithiasis Combined with High Hepatic Duct Strictures / 中国普外基础与临床杂志

ABSTRACT

Objective To discuss the effective surgical treatment of intrahepatic lithiasis combined with high hepa-t ic duct strictures. Methods Two hundreds and sixteen cases of intra hepatic lithiasis and high hepatic duct strictures treated in this hospital fr om January 1993 to October 2002 were analysed retrospectively.Results One hundred and eighty- three cases underwent different selective operation by selected time; 33 case s complicated with acute obstructive suppurative cholangitis underwent emergency were performed single biliary drainage, in which 30 cases were re-operated. Th e operative procedure were hepatic lobectomy,high cholangiotomy and plastic repair,exposure of hepatic duct of the 2nd and the 3rd order,and plastic re pair with own patch and choledochojejunostomy.Two hundreds and six cases w ere cured,the curative rate was 95.4%; 8 cases improved (3.7 %), and 2 cases died (0.9%).Conclusion The best effective surgical treat ment of intrahpatic lithiasis is hepatic lobectomy. Exposure of hepatic duct of the 2nd and the 3rd order is a satisfactory to release the hepatic duct str ictures and to clear the intrahepatic lithiasis. For patients with normal extr ahepatic bile duct and Oddi's function, plastic repair of bile duct with own patch is possible to keep the normal form and function. Cholang ioscopy may play an important role in the treatment of intrahepatic tr act lithiasis during operation.