摘要
胆囊结石与急性结石性胆囊炎是外科常见病。我国已进入老龄化社会, 老年患者是胆囊结石与急性结石性胆囊炎的高发群体, 其外科诊疗策略需要个体化制定, 根据患者的病情和所在医疗机构的医疗水平综合选择合理的诊疗方法。对于身体状况较好, 能耐受手术者建议以手术治疗为主, 首选是以腹腔镜胆囊切除术为主的微创手术。对于病情复杂或者患者全身情况不适宜行腹腔镜手术等情况, 开腹手术更为适宜, 可同时配合应用其他微创治疗措施。对于无法耐受手术治疗的患者可选择穿刺、内镜、介入等手段, 联合药物进行保守治疗, 争取获得手术治疗机会或改善预后。本文收集国内外最新研究文献, 对老年人胆道生理及老化特点、胆囊结石与急性结石性胆囊炎的诊断与治疗最新研究进展作一回顾及综述。希望本文能对此类疾病的临床诊治提供参考, 并对未来研究进行思考与展望。
Gallstones and acute calculous cholecystitis are common diseases in surgery.China has entered an aging society.Elderly patients are a high incidence group of gallstones and acute caleulous cholecystitis.Their surgical diagnosis and treatment strategies need to be formulated individully,and reasonable diagnosis and treatment methods should be comprehensively selected according to the patient's condition and the medical level of the medical institution.For those who are in good physical condition and can tolerate the operation,it is recommended to give priority to surgical treatment,and the minimally invasive surgery mainly suitable for laparoscopic choleystectomy(LC)is prefered.Open surgery is more appropriate for complicated conditions or patients whose general conditions are not suitable for laparoscopic surgery.Other minimally invasive treatment measures can be applied at the same time.For patients who can not tolerate surgical treatment,puncture,endoscopy,intervention and other means can be selected,combined with drugs for conservative treatment,so as to obtain the opportunity of surgical treatment or improve the prognosis.In this paper,the latest research literature at home and abroad has been collected to review and summarize the latest research progress in the physiology and aging characteristics of the biliary tract in the elderly,the diagnosis and treatment of gallstones and acute caleculous cholecystitis.It is hoped that this paper can provide reference for the clinical diagnosis and treatment of such diseases,and think and prospect the future research.
作者
许臣
顾利国
郑亚民
Xu Chen;Gu Liguo;Zheng Yamin(Department of General Surgery,Xuanwu Hospital,Capial Medical Universily,Bejing 100053,China)
出处
《国际外科学杂志》
2022年第8期572-576,共5页
International Journal of Surgery
关键词
老年人
胆囊结石病
胆囊炎
急性
诊断
治疗应用
急性结石性胆囊炎
Aged
Cholecystolithiasis
Cholecystitis,acute
Diagnosis
Therapeutic uses
Acute calculous cholecystitis
