Ermolov A S, Upyrev A V, Ivanov P A
Khirurgiia (Mosk). 2004(5):4-9.
Development of surgery of cholelithiasis is regarded. Classic surgical interventions on the gall bladder and bile ducts in complicated disease (acute cholecistitis, jaundice, cholangitis), postcholecistectomy syndrome, surgical trauma of the bile ducts are substantiated. To 1980s modern views on pathogenesis of the disease have been formed. However, unresolved problems of surgical policy, traumatism of open surgeries in complicated forms of the disease (postoperative lethality in acute cholecistitis was 37% and over) made results of treatment unsatisfactory. Correction of policy's problems, application of mini-invasive procedures, diapeutic approach and precision technique opened up-to-date period in surgery of cholelithiasis. It permitted to reduce postoperative lethality in acute and chronic course of the disease to 0.08 - 0.1%.
本文探讨了胆结石手术的发展历程。文中阐述了在复杂疾病（急性胆囊炎、黄疸、胆管炎）中对胆囊和胆管进行的经典外科干预、胆囊切除术后综合征以及胆管手术创伤的合理性。到20世纪80年代，关于该疾病发病机制的现代观点已经形成。然而，手术策略中尚未解决的问题，以及复杂疾病形式下开放手术的创伤性（急性胆囊炎术后死亡率达37%及以上）导致治疗效果不尽人意。手术策略问题的纠正、微创程序的应用、治疗方法和精准技术开启了胆结石手术的新时代。这使得该疾病急性和慢性病程的术后死亡率降低至0.08 - 0.1%。
