Sỏi trong gan: Cắt gan, xẻ gan lấy sỏi: Đặc điểm lâm sàng và kết quả điều trị

Hepatolithiasis is frequently meet in Asian especially in Vietnam. The cause of developping of intrahepatic stones is usually primary. Aim of study: The authors study the characteristics of hepatolithiasis and the results of hepatectomy and extraction of stones by hepatotomy. Patients and Methods: It is a retrospective study of all of patients who came to Binh Dan hospital to treat the intrahepatic stones from 2006 to 2010. Results: There are 157 patients, 55 males and 102 females that the middle age is 46,66. 90 percent of intrahepatic and 86 percent of extrahepatic stones. Stones in the left intrahepatic bile duct is 90 percent, in the right, 31 percent, bilateral, 16 percent. - Patient characteristics: Almost of them have had cholangitis due to bile duct stones. All have RUQ and epigastic pain. A half have fever and jaundice. - Hepatectomy is practiced in 150 cases. Hepatotomy for extration of stones in 7 cases. The primary results are obstained in 71 patients (45 percent), the stones are cleared. The retained stones are secondary extraction through dilatation of T tube during 2 to 6 months, so the final results are 88.54 percent. - Follow-up: with midlle time 12 months, the stones are retained and recurrent are 19 patients (12.7 percent), 11 patients have had extracted stones through the T tube during this time. Discussion: Almost came to us have had cholangitis with bile duct stones. Because the stones are localized almost in the left lobe with the liver, fibrosed and advanced inflammation, removing of the lobe is essential. The extraction of retained stones through T tube are of choice. The final results are obstained with 88.54 percent. In the follow-up average 12 months, the retained.and recurrent stones are 12.7 percent. Conclusion: When stones are localized in the duct of left liver, the surounding tissue are fibrosed and marked inflammation, removing of the left lobe is procedure of choice, though, it is necessary to break and removing of stones through dilatation of big T tube.