Poteriakhin V P
Klin Khir. 2010 Jan(1):18-20.
Results of surgical treatment of 52 patients for chronic calculous cholecystitis, complicated by cholelithiasis, were studied. In 26 (50%) patients as a first stage of treatment there was applied endoscopic papillosphincterotomy (EPST) and transpapillary endobiliary manipulations and then--laparoscopic cholecystectomy (CHE). In 13 (25%) patients as the first stage of treatment EPST and transpapillary endobiliary manipulations were performed, and as the second one--CHE through laparotomy. In 13 (25%) patients there were performed an open CHE. choledocholithotomy and one of variants of the biliary ducts drainage. In chronic calculous cholecystitis, complicated by cholelithiasis, the optimal treatment consists of complex endoscopic treatment. The combined and standard surgical tactic are indicated when application of endoscopic technologies is impossible.
对52例慢性结石性胆囊炎合并胆石症患者的手术治疗结果进行了研究。26例(50%)患者在治疗的第一阶段采用内镜乳头括约肌切开术(EPST)和经乳头胆道内操作,然后进行腹腔镜胆囊切除术(CHE)。13例(25%)患者在治疗的第一阶段进行了EPST和经乳头胆道内操作,第二阶段通过开腹手术进行CHE。13例(25%)患者进行了开放式CHE、胆总管切开取石术和胆管引流的一种变体。在慢性结石性胆囊炎合并胆石症中,最佳治疗方法是综合内镜治疗。当无法应用内镜技术时,应采用联合和标准的手术策略。