胆石切除术

Methods 30 cases of hepatolithiasis patients were divided randomly into following two groups: 15 did lobectomy of liver, 15 did choledocholithotomy.

30例肝内胆管结石的病人随机分成两组， 15例行肝叶切除术，另 15例行胆总管切开取石、 T管引流术。

Objective To explore clinic application of endoscopic retrograde cholangiopancreatography combined with laparoscopic cholecystectomy for the treatment of the cholecystic stone combined bile duct disease.

目的 探讨逆行胰胆管造影术联合腹腔镜胆囊切除术对胆囊结石伴胆管病变治疗的临床应用方法 27例胆囊结石伴胆道病变患者，先用ERCP、乳头切开术取石；或ERCP和鼻胆管引流及柱状气囊扩张术治疗，术后3～11天，患者无发热、腹痛，血淀粉酶正常，再按常规四孔法施行LC。

We performed cholecystectomy in 10 cases, cholecystectomy and choledochotomy for common bile duct exploration and stone removal and T-tube drainage in 2, partial cholecystectomy in 3, cholecystostomy in 1. Pathological examination showed that it was AGC in all the patients.

该组行胆囊切除术10例，胆囊切除+胆总管切开取石+T管引流术2例，胆囊大部切除术3例，胆囊造瘘术1例，术后病理报告均为急性坏疽性胆囊炎。

All of those who did choledocholithotomy had remaining calculi, and with the help of endoscope, 4 cases still had remaining calculi, only 33.3％ cases had excellent results.

行胆总管切开术的，术后残石 15例(100％)，经术后胆道镜，仍有 4例未取净。随访结果表明：肝叶切除术优良率为 80％，胆总管切开术的优良率为 33.3％。

Cases were undergone choledocholithotomy with T-tube drainage , 39 cases cholangiojejunostomy with T-tube drainage , 28 cases lobectomy of liver, 16 cases plastic repair of hepatic portle duct with cholangiojejunostomy.

其中肝胆管切开取石T管引流术47例，肝胆管切开取石+胆肠吻合术39例，肝部分切除术28例，肝门部胆管切开成形+胆肠吻合术16例。

We report a 67-year-old female admitted to our hospital with intermittent fever and upper abdominal pain. She had undergone cholecystectomy and choledocholithotomy 20 years previously. More recently, she had recurrent intrahepatic stones and underwent repeated choledocoscopic lithotiomy and endoscopic lithotripsy.

我们报告一位六十七岁女性因间歇性的发烧及上腹痛而住院，患者曾因胆及胆道结石在二十年前接受了胆囊切除术、胆道取石术，近几年又因复发的瞻道结石及胆管炎接受多次的胆道镜取石术及内视镜取石术。

Results 114 cases were follow-up surveyed from 6 months to 10 years, After operation,the superior rate and residual stone rate were respectively: it was 67.57%、54.05% in the group of choledocholithotomy with T-tube drainage ,78.38%、32.43% in cholangiojejunostomy with T-tube drainage , 96.15%、7.69% in lobectomy of liver, 85.71%、14.29% in plastic repair of hepatic portle duct with cholangiojejunostomy. The total superior rate was 79.82% and total residual stone rate was 31.58%.

结果 114例得到随访，随访6 月～10年，术后优良率及残石率分别：肝胆管切开取石T管引流术67.57%、54.05%，肝胆管切开取石+胆肠吻合术78.38%、32.43%，肝部分切除术96.15%、7.69%，肝门部胆管成形+胆肠吻合术85.71%、14.29%，总优良率79.82%、残石率31.58%。

The indications for the initial CT were the staging of small-bowel tumor and colon cancer, nonspecific abdominal discomfort, lier abscess, confirmation of the residual stone after open cholecystectomy and choledocholithotomy, and common bile duct stone and lier abscess.

所有病人均发现胰腺有异常，初始CT检查有小肠肿瘤和结肠癌、非特异性腹部不适、肝脓肿、胆囊切除术和胆总管石切除术后的残余结石、总胆管结石伴肝脓肿。

Results 114 cases were follow-up surveyed from 6 months to 10 years, After operation,the superior rate and residual stone rate were respectively: it was 67.57%、54.05% in the group of choledocholithotomy with T-tube drainage ,78.38%、32.43% in cholangiojejunostomy with T-tube drainage , 96.15%、7.69% in lobectomy of liver, 85.71%、14.29% in plastic repair of hepatic portle duct with cholangiojejunostomy. The total superior rate was 79.82% and total residual stone rate was 31.58%.

结果 114例得到随访，随访6个月～10年，术后优良率及残石率分别为：肝胆管切开取石T管引流术67.57%、54.05%，肝胆管切开取石+胆肠吻合术78.38%、32.43%，肝部分切除术96.15%、7.69%，肝门部胆管成形+胆肠吻合术85.71%、14.29%，总优良率79.82%、残石率31.58%。

Results 114 cases were follow-up surveyed from 6 months to 10 years, after operation,the superior rate and residual stone rate were respectively: it was 67.57%、54.05% in the group of choledocholithotomy with t-tube drainage ,78.38%、32.43% in cholangiojejunostomy with t-tube drainage , 96.15%、7.69% in lobectomy of liver, 85.71%、14.29% in plastic repair of hepatic portle duct with cholangiojejunostomy.

结果 114例得到随访，随访6个月～10年，术后优良率及残石率分别为：肝胆管切开取石t管引流术67.57%、54.05%，肝胆管切开取石+胆肠吻合术78.38%、32.43%，肝部分切除术96.15%、7.69%，肝门部胆管成形+胆肠吻合术85.71%、14.29%，总优良率79.82%、残石率31.58%。

The split between the two groups can hardly be papered over.

这两个团体间的分歧难以掩饰。

This approach not only encourages a greater number of responses, but minimizes the likelihood of stale groupthink.

这种做法不仅鼓励了更多的反应，而且减少跟风的可能性。