Clinical Analysis Of Three Operation Ways For The Treatment Of Intrahepatic Lithiasis

Objective：In our country, the relative incidence of Intrahepatic lithiasis has trend to low down.But it is still a common surgical disease. Clinical treatment is difficult. It should usesurgeon to get to comprehensive treatment. Intrahepatic lithiasis mainly has three operationmethodes：hepatectomy+T tube drainage，Roux-en-Y Choledochojejunostomy，high bileduct explore+T tube drainage. According to retrospective analysis, the study analyzethree diffirent operation mehods and treat effect. We try to evaluate the therapeutic value ofdifferent kinds of surgical methods. It will provide valuable reference for clinic.Materials and methods：Using retrospective method，I collect the data of146cases of Intrahepatic lithiasisin Jingjiang Traditional Chinese Medical Hospital from,1999,12, to2005,12. All of thecases were treated with the former three different kinds of operation methods. All get thefollow up. Comparing the three operaton methods of the postoperative complicationsrate，stone residua rate，stone recurrence rate，cholangitis rate. The follow-up time is from5to7years.Result：The postoperative stone residual rate of the group which was underwent hepatectomy+T tube drainage was10.14%,and it was obviously lower than that of Roux-en-YCholedochojejunostomy，high bile duct explore+T tube drainage.(P＜0.05),The otherearly complication rate had no diffference. But the stone recurrence rate(10.87%) andcholangitis rate(13.04%) of hepatectomy+T tube drainage was far lower than inhepatectomy+T tube drainage T–tube patient(P＜0.05).Conclusion:1. The causes of intrahepatic lithiasis are complicated.It should be based on specific cases to take proper operation mode,and combination of various methods of treatment；2.Hepatectomy+T tube drainage is resection of diseased liver,and retained thefunction of Oddis sphincter.It can reduce the postoperative residual stone rate, stonerecurrence rate and Cholangitis recurrence rate.Its re-operateion rate is low (P<0.05).It isbetter than the other two operation methods.It is the best surgical treatment of intrahepaticlithiasis.3. Roux-en-Y Choledochojejunostomy plays an important complementary role in thetreatment of intrahepatic lithiasis.Its postoperative complications rate is less， but the stoneresidua rate，stone recurrence rate，cholangitis recurrence rate is high；4. High bile duct drainage+T tube is only applicable to critical conditions or simpleand mild cases. It can achieve better effects.