摘要
胆总管结石是胆道系统常见病,更是一种复发性疾病,可因胆道梗阻引起剧烈腹痛,甚至引发急性梗阻性化脓性胆管炎,严重危害人类生命健康。目前治疗标准是当发现结石时,应取净结石,但随着胆总管结石的发病率不断上升,其处理方式也不断更新迭代,究其目的而论,最终结果均为胆总管取净结石,然而每一种方式不仅所使用设备不同,而且进入胆总管的入口、路径也有差异。本文从经皮经肝入路的经皮经肝十二指肠乳头肌扩张顺行排石术(percutaneous transhepatic papillary balloon dilation, PTPBD)、经胆总管入路的腹腔镜胆总管探查取石术(laparoscopic common bile duct exploration, LCBDE)、经胆囊管入路的经胆囊管腹腔镜胆总管探查术(laparoscopic transcystic common bile duct exploration, LTCBDE)、经T管窦道入路的窦道取石、经内镜逆行胰胆管入路的内镜下逆行胰胆管造影术(endoscopic retrograde cholangiopancreatography, ERCP)对胆总管结石临床治疗作详细综述。
Choledocholithiasis is a common and recurrent biliary disease.It can cause severe abdominal pain due to bile duct obstruction and may even to acute obstructive suppurative cholangitis,posing serious threatens to human health.The treatment standard is complete stone removal upon diagnosis.With the increasing incidence of choledocholithiasis,treatment methods have continuously evolved.Although the ultimate goal of all treatment methods is to achieve complete clearance of stones from the common bile duct,each approach differs in terms of the equipment used,as well as the entry site and pathway into the bile duct.This review provides a detailed overview of the clinical treatments,including:percutaneous transhepatic papillary balloon dilation(PTPBD)via the percutaneous transhepatic route,laparoscopic common bile duct exploration(LCBDE)through direct access to the common bile duct,laparoscopic transcystic common bile duct exploration(LTCBDE)via the cystic duct,T-tube tract stone extraction via a pre-existing sinus tract,and endoscopic retrograde cholangiopancreatography(ERCP)through the endoscopic retrograde pancreatobiliary route.
作者
丁懿晖
徐浩宇
马路
折占飞
DING Yihui;XU Haoyu;MA Lu;SHE Zhanfei(Inner Mongolia Medical University,Ordos,Inner Mongolia 017000,China;不详)
出处
《中华全科医学》
2025年第8期1387-1390,共4页
Chinese Journal of General Practice
基金
内蒙古自治区卫生健康科技计划项目(202201584)
鄂尔多斯市医学重点学科建设项目(20201207)
鄂尔多斯市科技领军人才项目(鄂财科指[2022]711号)。
关键词
胆总管结石
取石入路
外科治疗
Choledocholithiasis
Lithotomy approach
Surgical treatment
