胆囊结石:胆囊切除还是保胆取石?

For gallbladder stones: cholecystectomy or cholecystolithotomy

胆囊结石的治疗方法存在不同的主张,争论的焦点主要是切除胆囊还是保留胆囊。腹腔镜胆囊切除术(laproscopic cholecystectomy,LC)手术创伤小、术后恢复快,是治疗胆囊良性疾病的首选,在全世界普遍开展。然而,胆囊切除后可能出现消化不良、胆囊切除术后综合征、结肠癌发病率升高等一系列问题。内镜微创保胆取石(endoscopic minimally invasive cholecystolithotomy,EMIC)运用胆道镜、腹腔镜等微创技术达到去除结石并保留胆囊的目的 ,阻碍其进一步推广的问题在于该术式结石复发率偏高,缺乏大规模临床研究。因此对于胆囊结石不应简单归类于"切"与"保",而是结合患者的个体情况及本身的医疗条件决定处理方式。

Different propositions exist in the treatment of gallbladder stones, and the focus of the debate is mainly to remove the cholecyst or to remain it. Laproscopic cholecystectomy（LC） is the preferred choice to cure the benign diseases of the cholecyst for its little trauma and quick recovery,and for which it is generally applied all over the world. However, a series of problems such as indigestion, postcholecystectomy syndrome and higher incidence of colon cancer may occur after this operation. Endoscopic minimally invasive cholecystolithotomy（EMIC） uses minimally invasive technique like choledochoscope and laparoscope to remove the stones and meanwhile remain the cholecyst. What prevents it being further promoted is its high rate of recurrence and lack of large-scale clinical research. Therefore, for gallbladder stones, we should not simply class them as cut or remaining, but combine the patient＇s individual situation and the actual medical condition to choose the best treatment.