| 刘君毅.胆石症再次手术.[J].中南医学科学杂志.,1987,(2):. |
| 胆石症再次手术 |
| REOPERATIONS FOR CHOLELITHIASIS |
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| DOI： |
| 中文关键词: 残余结石,择期手术,正确处理 |
| 英文关键词:residul stones selected operations proper treatment |
| 基金项目: |
| 刘君毅 |
| 衡阳医学院第二附属医院外科 |
| 摘要点击次数: 745 |
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| 中文摘要: |
| 本文报告1976.1～1986.12十一年中,共施行胆石症手术351例。其中再次手术40例,占11.3％。40例中,首次手术17例在外院进行,23例在本院进行。本院334例胆石症手术中,再次手术率为6.8％。肝内外残余结石引起胆道感染是本组病例进行再次手术的主要原因。死亡3例,死亡率为7.5％。死亡原因,2侧由于胆道严重感染,1例由于胆道大出血。作者对胆石症再次手术的原因和如何减少再次手术,进行了讨论。认为尽量减少在急症情况下手术。择期手术前如能详细全面地进行检查,充分了解病情,术中彻底清除结石,切除病灶,处理好胆道狭窄,选择适当的术式,建立通畅的引流,避免术后逆行感染,在术中不发生意外损伤等,是手术一次成功的关键。 |
| 英文摘要: |
| Between January 1976 to December 1986, 40 among 351 cases of cholelithiasis were reoperated giving a reoperation rate of 11.3%, with 47 times of operation. The main cause of reoperation were intra-or extra-hepatic residual stones resulting in biliary infections. Three patients died (7.5%) postoperatively, due to severe infection in two and postoperative massive bleeding from the intrahepatic duct in one Reasons of reoperation and how to avoid it were presented. The following points were stressed to destine best results: Firstly, emergency operations should be avoided as much as possible. The primary operation should be selected carefully after the inflammatory process had already been brought under control. Secondly, efforts should be made on the radical removal of residual calculi, proper treatment of strictures of the biliary tract and resections of the infectious, atrophic, functionless hepatic lobe or segment. And lastly, a suitable reconstruction as well a proper drainage of bile should be made to eliminate postoperative retrograde infections |
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