Objective To evaluate the combined surgical therapy for calculi of intrahepatic duct. Methods One hundred and eight cases of hepatolithiasis treated in our hospital from January 1986 to September 2003 were summarized ...Objective To evaluate the combined surgical therapy for calculi of intrahepatic duct. Methods One hundred and eight cases of hepatolithiasis treated in our hospital from January 1986 to September 2003 were summarized and analyzed retrospectively. The primary surgery included 57 cases of biliary tract exploration and cholangiolithotomy, 26 cases of cholangiojejunostomy, and 25 cases of partial hepatectomy. Of these cases, 156 operations were performed totally. There were 36 patients undergoing two or more operations for cholangiolithiasis problem. Fiberoptic choledochoscopy was employed to examine and remove the residual stones during and after operation in all cases. Results The residual stone rates were 57.89% (33/57), 26.92% (7/26), and 24.0% (6/25) for biliary tract exploration and cholangiolithotomy, cholangiojejunostomy, and partial hepatectomy, respectively. Fiberoptic choledochoscopy was utilized pre- and post-operatively for each patient, which was performed 2 to 9 times on each case. Following the combined treatment, the rate of residual stone after operation decreased to 12.96% (14/108). Conclusions The combined surgical therapy is valuable for resolving the problem of hepatolithiasis in most of the patients. Regarding the clinical outcomes of different surgical procedures, partial hepatectomy is superior to cholangiojejuno- stomy or biliary tract exploration and cholangiolithotomy. Fiberoptic choledochoscopy is also important to reduce the occurrence of residual stones and the rate of reoperation.展开更多
Hepatolithiasis is characterized by the presence of stones within the intrahepatic bile ducts proximal to the right and left hepatic ducts. It is universally recognized that the occurrence of hepatolithiasis is closel...Hepatolithiasis is characterized by the presence of stones within the intrahepatic bile ducts proximal to the right and left hepatic ducts. It is universally recognized that the occurrence of hepatolithiasis is closely related to cholangitis, cholestasis, abnormal bile metabolism, anatomical abnormality of bile ducts, malnutrition and low socio-economic status. Surgery is the primary treatment method for hepatolithiasis in clinic, but some patients may still suffer from recurrence or complications after surgery. Traditional Chinese medicine(TCM) has its own unique advantages in preventing and treating recurrence of calculi. This article mainly explored the key points of common syndromes, TCM nursing methods and health guidance of acute attack of hepatolithiasis in order to further develop the advantages of TCM, improve its efficacy and standardized its nursing behavior.展开更多
文摘Objective To evaluate the combined surgical therapy for calculi of intrahepatic duct. Methods One hundred and eight cases of hepatolithiasis treated in our hospital from January 1986 to September 2003 were summarized and analyzed retrospectively. The primary surgery included 57 cases of biliary tract exploration and cholangiolithotomy, 26 cases of cholangiojejunostomy, and 25 cases of partial hepatectomy. Of these cases, 156 operations were performed totally. There were 36 patients undergoing two or more operations for cholangiolithiasis problem. Fiberoptic choledochoscopy was employed to examine and remove the residual stones during and after operation in all cases. Results The residual stone rates were 57.89% (33/57), 26.92% (7/26), and 24.0% (6/25) for biliary tract exploration and cholangiolithotomy, cholangiojejunostomy, and partial hepatectomy, respectively. Fiberoptic choledochoscopy was utilized pre- and post-operatively for each patient, which was performed 2 to 9 times on each case. Following the combined treatment, the rate of residual stone after operation decreased to 12.96% (14/108). Conclusions The combined surgical therapy is valuable for resolving the problem of hepatolithiasis in most of the patients. Regarding the clinical outcomes of different surgical procedures, partial hepatectomy is superior to cholangiojejuno- stomy or biliary tract exploration and cholangiolithotomy. Fiberoptic choledochoscopy is also important to reduce the occurrence of residual stones and the rate of reoperation.
文摘Hepatolithiasis is characterized by the presence of stones within the intrahepatic bile ducts proximal to the right and left hepatic ducts. It is universally recognized that the occurrence of hepatolithiasis is closely related to cholangitis, cholestasis, abnormal bile metabolism, anatomical abnormality of bile ducts, malnutrition and low socio-economic status. Surgery is the primary treatment method for hepatolithiasis in clinic, but some patients may still suffer from recurrence or complications after surgery. Traditional Chinese medicine(TCM) has its own unique advantages in preventing and treating recurrence of calculi. This article mainly explored the key points of common syndromes, TCM nursing methods and health guidance of acute attack of hepatolithiasis in order to further develop the advantages of TCM, improve its efficacy and standardized its nursing behavior.
