基于临床分型的肝胆管结石病治疗策略

Treatment strategies of hepatolithiasis based on clinical clas⁃sification

肝胆管结石病是我国常见的胆道疾病,回顾其近70年的外科治疗,治疗方法不断改进,治疗水平不断提高,但总体治愈率仍不理想,目前还没有被公认和广泛接受的诊断与治疗指南。笔者团队结合近40年肝胆管结石病的治疗经验和近年来肝胆管结石病外科治疗相关进展,将肝胆管结石病分为原发型、炎症型、占位型和终末型4种类型,并针对个案选用不同综合治疗方案,期望更好地完成“同病异治”,更好地个体化选择手术方式和手术时机,从而不断提高肝胆管结石病精细化诊断与治疗水平。

Hepatolithiasis is a common biliary disease in China.Even though there was a great development in the treatment for hepatolithiasis over the past 70 years,its therapeutic effect is frustrating.At present,there is still no recognized and widely accepted guidelines for its diagnosis and treatment.Based on the 40 years of experience and recent advances in the treatment of hepatolithiasis,the author′s team developed a new classification of hepatolithiasis with four types:primary type,inflammatory type,space occupying type,and terminal type.This new classification is a benefit for treatment strategy selection which is consistent with the traditional Chinese medicine theory of“the same disease with different treatment”.This new classification may be helpful to select surgical methods and time individually,in order to improve the therapeutic effect of hepatolithiasis.