胆囊结石治疗策略的争论与选择:胆囊切除还是保胆取石

The managements of gallstone:cholecystectomy or gallstone removal with preserving the gallbladder

胆囊结石是外科常见病。腹腔镜胆囊切除术已成为胆囊结石治疗的金标准,但其无法保留胆囊功能。保胆取石从保留胆囊功能的角度治疗胆囊结石,在理论上具有合理性,但需大量更高级别的临床证据来验证其可行性。目前应开展关于胆囊切除手术远期并发症的流行病学调查和保胆取石的前瞻性研究,用循证医学的证据验证各自的优缺点与适应证。应严格把握胆囊切除的指征,对于功能良好的胆囊应积极开展保胆取石的临床研究,反对遇到胆囊结石就切除胆囊,也反对不顾指征地盲目保胆取石。

Gallstone is a common gastrointestinal disease. Laparoscopic cholecystectomy has become the golden treatment standard of cholecystolithiasis, however, it cannot preserve the gallbladder＇s function. To some degree, although Gallstone removal with preserving the gallbladder has theoretic rationality, it needs more high grade evidences to support its rationality. Epidemiological investigation of late COnlplications of cholecystectomy and prospective research on preserving the gallbladder should be made to illustrate the advantages and disadvantages of both methods. Either cholecystectomy or gallstone removal with preserving the gallbladder should be applied with strict indications. And we should do more researches on gallstone removal by gallbladder-preserving among patients with normal gallbladder function. We agree with neither the opinion of cholecystectomy in every gallstone patient nor that of preserving gallbladder without appropriate indication.