[1]陈 明　李 锋.胆总管结石的临床治疗进展[J].大众科技,2020,22(12):79-81.
　Progress in Clinical Treatment of Choledocholithiasis[J].Popular Science & Technology,2020,22(12):79-81.
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胆总管结石的临床治疗进展()
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《大众科技》[ISSN:1008-1151/CN:45-1235/N]

卷:
22
期数:
2020年12
页码:
79-81
栏目:
医药与卫生
出版日期:
2020-12-20

文章信息/Info

Title:
Progress in Clinical Treatment of Choledocholithiasis
作者:
陈 明　李 锋
（梧州市中医医院，广西 梧州 543002）
关键词:
总管结石; 临床治疗; 微创技术; 胆色素结石; 胆总管探查术; 内镜下球囊扩张术
Keywords:
choledocholithiasis clinical treatment minimally invasive technique pigment gallstone common bile duct exploration endoscopic balloon dilatation
文献标志码:
A
摘要:
胆总管结石指发生于胆总管内的结石，属于胆结石中复杂类型，一旦发生极易并发胰腺炎，进而提高临床治疗难度。对于胆总管结石体积越大、数量越多者，其肝胆功能、结构循环损伤更为严重，临床认为及早解除结石，并疏通胆总管，是改善患者预后的关键。目前，临床多采取手术方法治疗胆总管结石，传统手术方法为胆总管切开探查取石术，可取得确切疗效，在临床上普遍应用。随着微创外科技术的不断发展，胆总管结石的手术治疗也逐渐趋于微创化，微创手术不仅创伤性小，还具有操作简单、术后恢复快和出血量少等优点。除手术方法外，临床治疗胆总管结石还有非手术方法。文章现就胆总管结石的临床治疗进行综述。
Abstract:
Choledocholithiasis refers to the stones in the common bile duct,which belongs to the complex type of gallstones. Once it occurs, it is very easy to complicate pancreatitis, which will improve the difficulty of clinical treatment. The larger and more numerous the choledocholithiasis are, the more serious the damage of hepatobiliary function and structural circulation is. Clinically, it is considered that the key to improve the prognosis of patients is to remove the stones as soon as possible and dredge the common bile duct. At present, most of the common bile duct stones are treated by surgical methods. The traditional surgical method is choledocholithotomy and exploration, which can achieve exact curative effect and is widely used in clinical practice. With the continuous development of minimally invasive surgical technology, the surgical treatment of common bile duct stones is gradually becoming minimally invasive. Minimally invasive surgery is not only less traumatic, but also has the advantages of simple operation, quick recovery and less blood loss. In addition to surgical methods, clinical treatment of common bile duct stones also has non-surgical methods. This article reviews the clinical treatment of choledocholithiasis.

参考文献/References:

[1]　Liu J G, Wang Y J, Shu G M, et al. Laparoscopic versus en-doscopic management of choledocholithiasis in patientsundergoing laparoscopic cholecystectomy: a meta- analysis[J]. Journal of Laparoendoscopic and Advanced Surgical Techniques: Part A, 2014, 24(5): 287-294. [2]　田泽阳，徐晨龙，张立. 腹腔镜与开腹再次胆道手术治疗胆总管结石的临床对比[J]. 中华普外科手术学杂志(电子版)，2018，12(1): 82-84. [3]　钟家国，赵劲松，杨汉勇，等. LBEPS术中一期缝合与T管引流的临床效果比较[J]. 西南国防医药，2017，27(7): 719-721. [4]　姜庆贺，王爱芝，乔森. 腹腔镜与开腹胆总管切开取石术对血清Cor、C-P、FT3的影响分析[J]. 重庆医学，2016，45(28): 4002-4004. [5]　曾华平，刘凤祝，刘擎. 老年胆总管结石与中青年患者经腹腔镜胆总管探查取石并一期缝合治疗的比较研究 [J]. 中华普外科手术学杂志(电子版)，2018，12(4): 319- 322. [6]　Ito T, Jin K S, Okubo H, et al. Safety of immediate endo-scopic sphincterotomy in acute suppurative cholangitiscaused by choledocholithiasis[J]. World Journal of Gastrointestinal Endoscopy, 2016, 8(3): 180-185. [7]　王安琪，尹思能，刘进衡. 三镜联合经腹置入鼻胆管引流在老年肝外胆管结石中的应用[J]. 肝胆胰外科杂志，2018，30(6): 51-54. [8]　张烨，孙加林，胡行前，等. 腹腔镜胆囊切除术联合胆总管探查术与经内镜逆行胰胆管造影联合腹腔镜胆囊切除术的比较[J]. 临床外科杂志，2017，25(6): 434-436. [9]　李作安，张建民，钱长春，等. 逆行胰胆管造影联合内镜与腹腔镜联合胆道镜治疗单纯胆总管结石的临床效果[J]. 中国医药导报，2016，13(28): 56-59. [10] Lin C, Collins J N, Britt R C, et al. Initial cholecystectomywith cholangiography decreases length of stay comparedto preoperative MRCP or ERCP in the management of choledocholithiasis[J]. The American Journal of Surgery, 2015, 81(7): 726-731. [11] 陈伟，罗一帆，吕品，等. 胆总管一期缝合及鼻胆管引流治疗胆总管结石的疗效与安全性[J]. 中国普通外科杂志，2018，27(2): 175-181. [12] 古广强，李波，万祎，等. 腹腔镜胆囊切除联合术中内镜逆行胰胆管造影治疗老年胆囊结石合并胆总管结石 [J]. 中国普通外科杂志，2018，27(8): 968-975. [13] 周华波，陈安平，刘安，等. 腹腔镜下套管乳头扩张术与内镜下乳头微切开术治疗细径胆总管结石合并Oddi括约肌狭窄的疗效对比[J]. 中国内镜杂志，2017，23(10): 11-15. [14] Palma G D D. Minimally invasive treatment of cholecysto-choledocal lithiasis:The point of view of the surgical en-doscopist[J]. World Journal of Gastrointestinal Surgery, 2013, 5(5): 161-166. [15] Koc B, Adas G, Karahan S. Use of laparoscopic commonbile duct exploration for failed endoscopic bile duct stoneextractions[J]. Minerva Chirurgica, 2014, 69(4): 209-215. [16] 付忠，陈军，李晓毅. 十二指肠乳头小切开术联合球囊扩张术、内镜下机械碎石术治疗胆总管结石效果观察[J]. 山东医药，2016，56(25): 61-63. [17] 将承霖，钟芸诗，周平红. 胆总管困难结石的内镜治疗[J]. 实用医学杂志，2015，31(24): 4146-4148. [18] 高振华，王军宏，钱宏亮. 三镜联合治疗胆囊结石合并胆总管结石[J]. 中国微创外科杂志，2018，18(6): 521-522，527. [19] 金雷，戴萌，李蜀豫，等. 药物预防经内镜逆行胰胆管造影术后结石复发的疗效观察[J]. 中国内镜杂志，2018，24(5): 78-84. [20] 李璐璐，黄晓俊，潘慧，等. 排石汤对胆总管结石患者经内镜逆行性胰胆管造影术后胆汁成分的影响[J]. 兰州大学学报(医学版)，2015，41(3): 60-63.

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备注/Memo

备注/Memo:
【收稿日期】2020-10-11 【作者简介】陈明(1967－)，男，广西梧州市中医医院外三科主治医师，研究方向为临床外科学。
更新日期/Last Update: 2021-01-08