保胆取石术尚存争议的问题

Some controversies on cholecystolithotomy

保胆取石术是近10年来逐步兴起的一项技术。自出现伊始,就引起了学界广泛而激烈的争论。其主要焦点集中在术后结石复发率、手术适应证和结石复发原因等问题上。目前尚无高级别循证医学证据对"保胆"和"切胆"之争给出明确的答案。须明确,"保胆"不仅是在解剖上保留胆囊,更重要的是在功能上保留胆囊,使保留下来的胆囊仍能发挥正常的功能。如果胆囊丧失了正常的功能,盲目"保胆"势必为结石复发或发生其他胆囊疾病遗留后患。

Cholecystolithotomy is a new technique raised for nearly a decade. Since the first description in the world, the great controversy has been going on in the surgical field. The issues focus on the postoperative recurrence, indications of the choleeystolithotomy and the reasons of recurrence. Unfortunately, by now, there is no enough evidence to give the answer which is the better between cholecystolithotomy and chnlecystectomy. Nevertheless, the fundamental principle is that the gallbladder preservation is not only preserving the organ itself but also the normal function of the organ. If a diseased gallbladder is inappropriately preserved, it could be potential harmful to the patient.