Ponsky J L
Department of Surgery, Mt. Sinai Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio 44106.
World J Surg. 1992 Nov-Dec;16(6):1060-5. doi: 10.1007/BF02067062.
Endoscopic sphincterotomy has become the undisputed method of choice for removing common bile duct calculi following previous cholecystectomy. This approach has also been applied to selected patients with intact gallbladders deemed unfit for surgery. More recently, endoscopic clearance of the bile duct has been used in concert with laparoscopic cholecystectomy to avoid laparotomy. Modalities available for stone therapy via the endoscope include baskets and balloons, mechanical lithotripters, electrohydraulic lithotripsy probes, and laser energy. In difficult cases stents may be placed to provide drainage in lieu of stone extraction.
内镜括约肌切开术已成为胆囊切除术后清除胆总管结石的无可争议的首选方法。这种方法也已应用于部分被认为不适合手术的胆囊完整的患者。最近，胆管内镜清除术已与腹腔镜胆囊切除术联合使用，以避免开腹手术。通过内镜进行结石治疗的方式包括网篮和球囊、机械碎石器、液电碎石探头和激光能量。在困难病例中，可放置支架以提供引流而非取石。
