“保胆”还是“切胆”:对胆囊结石治疗的再思考

“Gallbladder preserving”or“cholecystectomy”:rethinking on the treatment of cholecystolithiasis

胆囊结石是我国乃至全球的常见病,主要治疗方式是腹腔镜胆囊切除术。然而,随着内镜技术的发展,加之为避免胆囊切除的并发症,强调结合患者意愿的“保胆”手术,也在开展之中。本文参考国内、外指南和相关文献资料,结合临床工作实际,从胆囊结石产生的病因和机制、胆囊的功能、胆囊切除术后的并发症,以及胆囊结石治疗方案的合理选择几个方面进行阐述,供临床参考及讨论。

Cholecystolithiasis is a common disease in China and even worldwide,which is mainly treated by laparoscopic cholecystectomy.However,with the development of the choledochoscopic techniques,and in order to avoid the complications of cholecystectomy,“gallbladder-preserving”cholecystolithotomy that emphasizes the patients wishes is also being carried out.With reference to domestic and foreign guidelines and relevant literatures,combined with clinical practice,this article expounds the etiology and mechanism of gallstones,gallbladder functions,complications after cholecystectomy and reasonable choice of treatment plan for gallstone for clinical references and discussion.