摘要
胆结石的发病率为5%~15%,其中5%~30%合并胆总管结石。随着医疗技术的发展和术后加速康复外科的需要,创伤更小、恢复更快的腹腔镜胆总管探查术和经内镜逆行胰胆管造影术正逐步取代开腹胆总管切开术,并成为目前治疗胆总管结石的主要手段。胆总管结石微创治疗的结石清除率可高达95%,然而其复发率却没有降低(4%~25%)。因此,探明胆总管结石术后复发的危险因素并降低复发率是目前胆胰外科的研究重点。本文通过查阅相关文献,从年龄与性别、遗传基因、生活方式和药物干预、胆道微环境紊乱、胆道解剖因素、手术治疗方式、结石复发次数等7个方面对胆总管结石复发的危险因素作一综述,以期为结石复发的预防和治疗提供新的方向。
The incidence of cholelithiasis is 5%-15%,of which 5%-30%is combined with common bile duct stones(CBDS).With the development of medical technology and the need for enhanced recovery after surgery,laparoscopic common bile duct exploration and endoscopic retrograde cholangiopancreatography are gradually replacing open choledochotomy with less trauma and faster recovery,and becoming the main means for CBDS.The stone clearance rate of CBDS minimally invasive treatment can be as high as 95%,while the recurrence rate has not been decreased(4%-25%).Therefore,identifying the risk factors for recurrence after CBDS operation and reducing the recurrence rate is the focus of current research in biliary and pancreatic surgery.This article reviewes the risk factors of CBDS recurrence from seven aspects,including age,gender,genetics,lifestyle and drug intervention,biliary microenvironment disturbance,biliary anatomy factors,surgical treatment methods,and the number of stone recurrences,in order to provide better understanding of the recurrence of CBDS.
作者
蔡茗
俞亚红
Cai Ming;Yu Yahong(Department of Biliary and Pancreatic Surgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)
出处
《中华普通外科学文献（电子版）》
CAS
2022年第6期438-442,共5页
Chinese Archives of General Surgery(Electronic Edition)
关键词
胆总管结石
复发
危险因素
腹腔镜胆总管探查
胰胆管造影术
内窥镜逆行
Common bile duct stones
Recurrence
Risk factors
Laparoscopic common bile duct exploration
Cholangiopancreatography,endoscopic retrograde
