Browning Jeffrey D, Horton Jay D
Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390-9046, USA.
Semin Gastrointest Dis. 2003 Oct;14(4):165-77.
Gallstone disease is one of the most common disorders of the gastrointestinal tract, and more cholecystectomies are performed each year in the United States than any other elective abdominal operation. As such, clinicians need a fundamental knowledge of gallstone disease and the common complications that are associated with this disease. Overall, the prevalence of gallstones in the United States is approximately 10% to 15%, of which, approximately 80% are without symptoms. Symptoms will occur in approximately 20% of those with gallstones, and this subgroup is at the highest risk for developing serious complications from their gallstone disease. These complications can range from simple recurrent biliary colic to severe, life-threatening ascending cholangitis and/or pancreatitis. This review will outline the basis for gallstone formation, the underlying mechanisms that result in gallstone-induced symptoms and a rational approach to individuals who present with symptoms consistent with gallstone disease. Current diagnostic and treatment modalities will be discussed, with a particular emphasis on acute cholecystitis and acute biliary pancreatitis.
胆结石病是胃肠道最常见的疾病之一，在美国，每年进行胆囊切除术的次数比其他任何择期腹部手术都要多。因此，临床医生需要掌握胆结石病的基本知识以及与该疾病相关的常见并发症。总体而言，美国胆结石的患病率约为10%至15%，其中约80%没有症状。约20%的胆结石患者会出现症状，这一亚组发生胆结石病严重并发症的风险最高。这些并发症范围从简单的复发性胆绞痛到严重的、危及生命的上行性胆管炎和/或胰腺炎。本综述将概述胆结石形成的基础、导致胆结石引发症状的潜在机制以及对出现与胆结石病相符症状的个体的合理处理方法。将讨论当前的诊断和治疗方式，特别强调急性胆囊炎和急性胆源性胰腺炎。
