Kết quả sớm của phẫu thuật cắt gan bên trái điều trị sỏi trong gan

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Tác giả: Duy Trường Lương, Chí Quang Nguyễn, Lâm Trường An Nguyễn, Văn Hùng Võ, Thừa Đức Vương

Ngôn ngữ: vie

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Thông tin xuất bản: Tạp chí Y Dược học Phạm Ngọc Thạch, 2023

Mô tả vật lý: tr.148

Bộ sưu tập: Metadata

ID: 339321

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- Đặt vấn đề: Sỏi trong gan là một bệnh lý phổ biến và đặc trưng của phương Đông do có tần suất cao ở một số nước Châu Á. Bệnh sinh sỏi trong gan phức tạp và hiểu biết chưa hoàn toàn, thường diễn tiến gây nên nhiễm trùng đường mật tái diễn và đưa đến những biến chứng nặng nề như: áp xe gan đường mật, xơ hẹp các đường mật trong gan, xơ gan do ứ mật và ung thư đường mật, khả năng làm sạch sỏi khó và tỉ lệ tái phát cao. - Mục tiêu nghiên cứu: (1) Mô tả đặc điểm lâm sàng và cận lâm sàng của bệnh nhân mắc bệnh sỏi trong gan trái, và chỉ định cắt gan bên trái. (2) Xác định kết quả sớm của phẫu thuật cắt gan bên trái ở những bệnh nhân bị sỏi trong gan trái qua: tỉ lệ sạch sỏi, tai biến, biến chứng và tử vong. - Phương pháp nghiên cứu và đối tượng: Nghiên cứu mô tả, hồi cứu. Những bệnh nhân có sỏi trong gan trái ± sỏi trong gan phải ± sỏi ống mật chủ ± sỏi túi mật được phẫu thuật cắt gan bên trái tại bệnh viện Bình Dân từ tháng 11/2018 đến tháng 5/2021- Kết quả: 54 bệnh nhân có sỏi trong gan trái ± sỏi ống mật chủ ± sỏi túi mật được phẫu thuật cắt gan bên trái tại bệnh viện Bình Dân từ tháng 11/2018 đến tháng 5/2021. 40 - 70 tuổi, tỉ lệ nữ: nam 2.4:1, dân cư có đời sống kinh tế xã hội và dinh dưỡng kém. Nhập viện với triệu chứng đau bụng, vàng da và sốt, và nhiễm trùng đường mật với tam chứng Charcot. Kết quả phẫu thuật: thời gian nằm viện trung bình 16,96 ± 4,8 ngày. Hiệu quả sạch sỏi cao: 45 trường hợp được giải quyết sạch sỏi hoàn toàn (83,3%), và tỉ lệ này tăng lên 100% khi tán sỏi. Tỉ lệ tử vong 0%, tỉ lệ biến chứng thấp 33,3%- Kết luận: Phẫu thuật cắt gan bên trái là phẫu thuật có hiệu quả sạch sỏi cao, lấy được thương tổn gan đường mật mạn tính, và ít tai biến biến chứng.Abstract- Background: Intrahepatic stoneisa common and characteristic disease of the East because of itshigh frequency in some Asian countries. The pathogenesis of gallstones in the liverwhich is complex and incompletely understood, often progresses. This causes recurrent biliary tract infections and leads to serious complications such as liver and biliary abscesses. Cirrhosis of the intrahepatic bile ducts, cirrhosis of the liver due to cholestasis and cholangiocarcinoma. In additions, the ability to clear stones is difficult and the recurrence rate is high. - Aims: (1) Describingclinical and subclinical characteristics of a patient with gallstone disease in the left liver, and indication for left hepatectomy. (2) Determining the early results of left hepatectomy in patients with stones in the left liver: stone clearance rates, complications and mortality.- Material and Method: Descriptive, retrospective study. Patients with left liver stones ± right liver stones ± common bile duct stones ± gallstones underwent left hepatectomy at Binh Dan hospital from November 2018 to May 2021.- Results: 54 patients with left liver stones ± common bile duct stones ± gallstones underwent left hepatectomy at Binh Dan hospital from November 2018 to May 2021. The range of age was 40 - 70 years old
The female: male ratio was 2.4:1, the population withpoor socio - economic life and poor nutrition. Hospitalization with abdominal pain, jaundice and fever, and biliary tract infection with Charcot triad. Surgical results: average hospital stay 16.96 ± 4.8 days. High stone removal efficiency: 45 cases completely cleared of stones (83.3%), and the rate up to 100% with lithotripsy. Mortality rate 0%, low complication rate 33.3 %- Conclusions: Left - sided hepatectomy is a highly effective surgery to remove stones, remove chronic liver and biliary tract damageand low complications. DOI: 10.59715/pntjmp.1.2.17

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