Sándor J
3rd Surgical Department, Semmelweis University Medical School, Budapest.
Acta Biomed Ateneo Parmense. 1992;63(1-2):51-7.
After the first cholecystectomy performed by Karl Lagenbuch in 1882 this method has become the choice for treating gallstone disease. Today mortality of this operation is less than 1%. In spite of this fact clinicians tried to find non-operative possibilities to get rid of gallstones. Litholysis performed either by oral way or percutaneous, transhepatic or retrograde, transcystic method can be used only for cholesterol stones which represent only 10% of gallstones. Intracorporeal lithotripsy by percutaneous way is an invasive method. Extracorporeal shock wave lithotripsy can be applied only for cholesterol stones of certain number, but even after careful selection of the patients only 80% become stone free in one year. All the methods which leave the gallbladder intact are not free of complications and they are followed by 50% stone recurrence in 5 years. From 1987 a new surgical procedure: laparoscopic cholecystectomy has spread all over the world. Laparoscopic surgical technique is the way to the future.
1882年卡尔·拉根布赫首次进行胆囊切除术后，这种方法成为治疗胆结石疾病的首选。如今，该手术的死亡率低于1%。尽管如此，临床医生仍试图寻找非手术方法来消除胆结石。通过口服、经皮、经肝或逆行、经胆囊途径进行的溶石治疗仅适用于占胆结石总数仅10%的胆固醇结石。经皮体内碎石术是一种侵入性方法。体外冲击波碎石术仅适用于一定数量的胆固醇结石，但即使在仔细挑选患者后，一年内也只有80%的患者结石消失。所有保留胆囊的方法都并非没有并发症，并且5年后结石复发率为50%。自1987年以来，一种新的外科手术：腹腔镜胆囊切除术已在全球普及。腹腔镜手术技术是未来的发展方向。
