Wang Jeffrey K, Foster Shannon M, Wolff Bruce G
Perm J. 2009 Spring;13(2):50-4. doi: 10.7812/TPP/08-050.
Gallstones develop in approximately 10% to 15% of the US population and represent one of the most common and most costly of all digestive diseases. Studies investigating gallstones' natural history have shown that gallstone-related complications arise at a rate of approximately 1% per year in asymptomatic patients and 2% per year in patients who already have symptoms. Patients can have any of multiple presentations with gallstone-related problems along a continuum of health threats from intermittent biliary colic to septic shock from ascending infections. In most clinical situations in which the patient's gallstone symptoms are either recurrent or have caused complications, cholecystectomy remains the procedure of choice. Laparoscopic cholecystectomy, first performed in the mid-1980s, has quickly become the gold standard in the US. For clinicians who perform abdominal procedures, the literature is consistent in advocating cholecystectomy for gallstones found incidentally during other abdominal procedures.
在美国,约10%至15%的人口会患上胆结石,胆结石是所有消化系统疾病中最常见且治疗成本最高的疾病之一。对胆结石自然病史的研究表明,无症状患者中与胆结石相关的并发症每年发生率约为1%,已有症状的患者中每年发生率为2%。患者可能会出现多种与胆结石相关的症状,这些症状构成了一系列健康威胁,从间歇性胆绞痛到上行性感染导致的感染性休克。在大多数临床情况下,若患者的胆结石症状反复出现或已引发并发症,胆囊切除术仍是首选治疗方法。20世纪80年代中期首次开展的腹腔镜胆囊切除术,迅速成为美国的金标准。对于进行腹部手术的临床医生而言,文献一致主张对在其他腹部手术中偶然发现的胆结石进行胆囊切除术。