肝内胆管结石的临床诊治进展

The clinical progress in the diagnosis and treatment of intrahepatic stone

近年来肝内胆管结石的发病率有所下降,但国内发病人数仍然众多。肝内胆管结石具有病情复杂、并发症多、复发率高及全身损害严重的特点,目前诊断主要依靠影像学检查。虽然肝内胆管结石的治疗方式多样,临床还是以内镜和手术治疗为主,前者主要是经皮肝胆道镜碎石取石术,后者主要包括腹腔镜下胆管切开取石术、肝切除术、肝门胆管狭窄成形术以及肝移植术。本文对肝内胆管结石的诊断及治疗现状和进展进行论述。

The incidence of intrahepatic stone declined in recent years, but the number of patients with intrahepatic stone is still in a large quantity in China. Intrahepatic stone is characterized by complex, many complications, high recurrence and serious systemic damage. At present, the diagnosis of intrahepatic stone mainly relies on imaging examination. Although treatment is diversiform, the endoscopic and surgical techniques are commonly used clinically. The endoscopic therapy refers to percutaneous transhepatic cholangioscopic lithotripsy（PTCSL） and the surgical approach includes laparoscopic bile duct incision and lithotomy, hepatic resection, reconstruction of bile duct stricture and liver transplantation. In this paper, the current status and progress of diagnosis and treatment of intrahepatic stone are discussed.