提高对胆石性肠梗阻的认识

Focus on management of gallstone ileus

胆石性肠梗阻是一种少见的肠梗阻,也是胆石病的一种严重并发症.该症的发病率上升与结石病发病率不断攀升、社会老龄化以及诊断技术水平提高等因素有关.该病缺乏典型的临床表现,多数情况下病情复杂,容易延误诊疗.本文复习相关文献,重点阐述了胆石性肠梗阻的发病机制、延误因素和临床诊治策略,强调在临床上应充分认识胆石性肠梗阻的特殊性和复杂性,并在遵从基本原则的基础上进行合理化个案化诊疗,以改善胆石性肠梗阻的预后.

Gallstone ileus is a rare form of intestinal obstruction and an uncommon complication of gallstone disease resulting from the impaction of one or more gallstones in the bowel owing to biliary intestinal fistula.The increasing incidence of gallstone ileus is related to the high prevalence of cholelithiasis, the aging of thepopulation, and the more sensitive diagnostic tools.The diagnosis is often delayed due to the lack of typicalclinical manifestations. In this paper, we discuss thepathogenesis of gallstone ileus, factors that result in itsdiagnosis, and therapeutic strategies by performing asystematic review of the literature. We also emphasizethe specificity and complexity of gallstone ileus.We suggest that on the basis of observing the basicprinciples, the management should be rationalized andindividualized in clinical practice so as to improve theprognosis of gallstone ileus.