Wetter L A, Way L W
Department of Surgery, University of California, San Francisco.
Gastroenterol Clin North Am. 1991 Mar;20(1):157-69.
Surgery, in particular laparoscopic cholecystectomy, will probably remain the preferred treatment for symptomatic gallbladder stones. It is unlikely that other methods of treatment, such as oral dissolution therapy or lithotripsy, can match the results and patient acceptance of this procedure. With the advent of laparoscopic cholecystectomy, however, more patients with choledocholithiasis will undergo endoscopic sphincterotomy and endoscopic common bile duct clearance. This may change, however, if the common bile duct can be explored safely through the laparoscope. Finally, severe gallstone pancreatitis will continue to be treated by early endoscopic sphincterotomy followed by cholecystectomy. Nevertheless, endoscopic sphincterotomy alone will be used more often as a definitive treatment to prevent recurrent attacks, especially in elderly patients who are poor candidates for cholecystectomy.
手术，尤其是腹腔镜胆囊切除术，可能仍将是有症状胆囊结石的首选治疗方法。其他治疗方法，如口服溶石疗法或碎石术，不太可能在疗效和患者接受度方面与该手术相媲美。然而，随着腹腔镜胆囊切除术的出现，更多胆总管结石患者将接受内镜括约肌切开术和内镜下胆总管清理术。不过，如果能通过腹腔镜安全地探查胆总管，情况可能会有所改变。最后，重症胆石性胰腺炎仍将通过早期内镜括约肌切开术随后行胆囊切除术进行治疗。尽管如此，内镜括约肌切开术单独作为确定性治疗以预防复发的情况将更频繁地使用，尤其是对于不适合进行胆囊切除术的老年患者。
