肝胆管结石外科治疗进展

Recent advances in surgical treatment of hepatolithiasis

肝胆管结石病是我国常见而难治的胆道疾病,其病情复杂、并发症多、复发率高、并有恶变的可能,其治疗问题仍然是当前胆道外科面临的难题。目前对肝胆管结石的治疗仍以外科治疗为主,包括胆管切开取石、肝部分切除、胆管狭窄修复重建及肝移植术等多种方法,其中肝部分切除术是当前公认为治疗肝胆管结石最有效的方法。近年来,肝胆管结石外科手术疗效已有明显提高,但术后仍可能面临残余结石、结石复发及再次手术等诸多问题,必须加以高度重视。

Hepatolithiasis is prevalent in developing countries in East Asia, especially in China. Hepatolithiasis is characterized by its intractable nature and frequent recurrence, requiring multiple operative interventions, which pose a therapeutic challenge to biliary surgeons. In this article, the classification of hepatolithiasis is introduced and features of intrahepatic stones are described. It is a comprehensive review of the various surgical modalities currently in use to treat hepatolithiasis. Surgery remains the most definitive treatment for hepatolithiasis. Complete removal of the diseased lobe or segment is crucial to prevent recurrence and progressive liver disease.