First Department of Internal Medicine, Gifu University Hospital, Gifu, Japan.
Dig Endosc. 2010 Jul;22 Suppl 1:S76-8. doi: 10.1111/j.1443-1661.2010.00957.x.
Endoscopic treatment is now recognized as the standard treatment for common bile duct stones worldwide. Endoscopic treatment routinely involves endoscopic sphincterotomy in most countries including Japan and endoscopic papillary balloon dilation is also a widely used alternative to endoscopic sphincterotomy in Japan. Surgery in any form, including laparoscopic surgery, is mainly performed when endoscopic treatments are unsuccessful or unfavorable. Other therapeutic modalities considered under certain circumstances include lithotripsy under the guidance of percutaneous transhepatic cholangioscopy, peroral cholangioscopy, or enteroscopy; electrohydraulic lithotripsy or laser lithotripsy; and extracorporeal shock-wave lithotripsy.
内镜治疗目前被公认为全世界治疗胆总管结石的标准治疗方法。内镜治疗通常包括在大多数国家（包括日本）进行内镜下括约肌切开术，而内镜下乳头气囊扩张术也是日本广泛应用的内镜下括约肌切开术替代方法。在任何形式的手术中，包括腹腔镜手术，主要是在内镜治疗不成功或不适合时进行。在某些情况下，还可以考虑其他治疗方法，包括经皮经肝胆道镜引导下的碎石术、经口胆管镜或经肠镜下的碎石术；液电碎石术或激光碎石术；以及体外冲击波碎石术。
