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[肝内胆管结石的诊断与治疗问题]

[Problems in the diagnosis and treatment of intrahepatic lithiasis].

作者信息

Popa G, Medianu D

出版信息

Rev Chir Oncol Radiol O R L Oftalmol Stomatol Chir. 1976 Mar-Apr;25(2):103-10.

PMID:133389
Abstract

Following the study of 44 cases of intra-hepatic lithiasis the authors have reached these conclusions:--intra-hepatic lithiasis (both primary and secondary) represents 3% of the biliary lithiases;--the characteristic element of the evolution of biliary lithiasis is the so-called "ageing phenomenon" leading to the formation of multiple stones, progressively obstructing the biliary pathways and finally involving the intra-hepatic segments. These are the so-called biliary panlithiases representing 50% of the cases with intra-hepatic lithiasis in the author's statistics;--cholangiography (both intravenous and intra-canalicular) should be considered as completed only when it provides a representation of the entire biliary system;--one cannot speak at present of a "remaining" or "forgotten" hepato-choledocus stone before the exclusion of the intra-hepatic "forgotten" stone;--the significant reduction of "post-cholecystectomy disturbances" depends on the correct diagnosis and treatment of all stones, indifferent of their site of occurrence (extra- and intra-hepatic).

摘要

通过对44例肝内结石病例的研究,作者得出以下结论:——肝内结石(原发性和继发性)占胆石症的3%;——胆石症演变的特征性因素是所谓的“老化现象”,导致形成多个结石,逐渐阻塞胆管通路,最终累及肝内段。这些就是所谓的胆全石症,在作者的统计中占肝内结石病例的50%;——胆管造影(静脉内和小管内造影)只有在显示整个胆道系统时才应被视为完成;——在排除肝内“被遗忘”的结石之前,目前不能说存在“残留”或“被遗忘”的肝外胆管结石;——“胆囊切除术后不适”的显著减少取决于对所有结石的正确诊断和治疗,无论其发生部位(肝外和肝内)。

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