关键词: 肝切除术, 肝胆管结石, 美蓝试验, 胆漏

Abstract: Objective To analyze the clinical value of intraoperative methylene blue test in reducing the incidence of bile leakage after hepatectomy for hepatolithiasis.
Methods The clinical data of 58 patients after hepatectomy，from September 2018 to June 2019 in the second affiliated hospital of Kunming medical university was retrospectively analyzed.According to the therapy method，58 patients were divided into the methylene blue group（n=30）and comparative group（n=28）.The conditions for the methylene blue group are treated by using methylene blue text to verify whether biliary system is patency and whther the bile duct residual exist; The conditions for comparative group are treated by traditional white gauze cover or biliary injection test to find the bile leakage.The observational index are general information，operation time，intraoperative blood loss，intraoperative bile leakage decetion rate，postoperative bile leakage，total bilirubin of drainage，abdominal drainage tube removal time and total hospitalization days.
Results 58 patients were succeed in hepatectomy.There are 1 cases of bile leakage occurred，1 case of postoperative bleeding occurred and 3 case of infection in methylene blue group.Besides，There are 7 cases of bile leakage occurred，1 case of postoperative bleeding occurred and 4 case of infection in comparative group.They were cured after active symptomatic treatment.Intraoperative bile leakage decetion rate in the methylene blue group were high than comparative group.Postoperative bile leakage，total bilirubin of drainage，abdominal drainage tube removal time and total hospitalization days in the methylene blue group were all less than comparative group with statistically significant difference（P<0.05）.No statistically significance was observed in operation time，intraoperative blood loss，postoperative bleeding and infection between the two groups（P>0.05）.
Conclusion Intraoperative methylene blue test can effectively improve intraoperative bile leakage decetion rate and reduce the incidence of bile leakage after hepatectomy for hepatolithiasis.

Key words: hepatectomy, hepatolithiasis, Methylene blue test, bile leakage