Schildberg F W, Pratschke E
Klinikum Grosshadern, Chirurg. Klinik und Poliklinik, LMU München.
Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir. 1990:1219-24.
Nonsurgical methods compete with common bile duct exploration (CBDE) in the treatment of choledocholithiasis. Following CBDE residual duct stones are found in 6% of cases and the mortality is 2%. In our patients (n = 373) the numbers were 5.4% and 1.6% respectively. The lowest rates of residual duct stones were seen following a combination of intraoperative cholangiography and choledochoscopy. CBDE is indicated when cholecholithiasis is discovered intraoperatively, in low-risk patients with gallbladder and bile duct stones, after unsuccessful endoscopic procedures, in cases, of other pathologic findings of the bile duct requiring surgery or even in younger patients after prior cholecystectomy.
在胆总管结石的治疗中，非手术方法与胆总管探查术（CBDE）相互竞争。在进行胆总管探查术后，6%的病例会发现残留胆管结石，死亡率为2%。在我们的患者（n = 373）中，这两个数字分别为5.4%和1.6%。术中胆管造影和胆总管镜检查联合应用后，残留胆管结石的发生率最低。当术中发现胆结石、胆囊和胆管结石的低风险患者、内镜手术失败后、胆管存在其他需要手术的病理发现的病例，甚至是先前接受过胆囊切除术的年轻患者时，均需进行胆总管探查术。
