Kelly E, Williams J D, Organ C H
Department of Surgery, University of California, Davis-East Bay, Oakland, California, USA.
Am J Surg. 2000 Aug;180(2):86-98. doi: 10.1016/s0002-9610(00)00428-1.
Common duct calculi retained after gallbladder surgery continue to present a clinical challenge especially in the era of minimally invasive surgery. This review examines the strategy of dissolution therapy used throughout the history of biliary tract surgery and its use to the modern surgeon.
Original journal articles and reviews were identified using standard surgical textbooks and MEDLINE. Keywords for searching included choledocholithiasis, dissolution, mono-octanoin, common duct stones, MTBE, cholic acid, and gallstones.
Dissolution therapy used initially as an alternative to open surgery is now used more effectively as an adjunct to laparoscopic or endoscopic biliary tract surgery. The current review demonstrates a majority of patients with retained choledocholithiasis respond to dissolution and can be safely managed without choledochotomy.
胆囊手术后残留的胆总管结石仍然是一个临床挑战，尤其是在微创手术时代。本综述探讨了在胆道手术历史中使用的溶石疗法策略及其对现代外科医生的应用。
使用标准外科教科书和MEDLINE识别原始期刊文章和综述。搜索关键词包括胆总管结石、溶解、单辛脂、胆总管结石、甲基叔丁基醚、胆酸和胆结石。
最初作为开放手术替代方法使用的溶石疗法，现在作为腹腔镜或内镜胆道手术的辅助手段使用得更有效。当前综述表明，大多数残留胆总管结石患者对溶石有反应，并且可以在不进行胆总管切开术的情况下得到安全处理。
