Buxbaum James
Division of Gastrointestinal and Liver Diseases, Keck School of Medicine, Los Angeles County Hospital, University of Southern California, Los Angeles, CA 90033-1370, USA.
Gastrointest Endosc Clin N Am. 2013 Apr;23(2):251-75. doi: 10.1016/j.giec.2012.12.003. Epub 2013 Jan 21.
It is imperative for gastroenterologists to understand the different formations of bile duct stones and the various medical treatments available. To minimize the complications of endoscopic retrograde cholangiopancreatography (ERCP), it is critical to appropriately assess the risk of bile duct stones before intervention. Biliary endoscopists should be comfortable with the basic techniques of stone removal, including sphincterotomy, mechanical lithotripsy, and stent placement. It is important to be aware of advanced options, including laser and electrohydraulic stone fragmentation, and papillary dilatation for problematic cases. The timing and need for ERCP in those who require a cholecystectomy is also a consideration.
胃肠病学家必须了解胆管结石的不同形成方式以及现有的各种医学治疗方法。为了将内镜逆行胰胆管造影术（ERCP）的并发症降至最低，在干预前适当评估胆管结石的风险至关重要。胆道内镜医师应熟悉结石清除的基本技术，包括括约肌切开术、机械碎石术和支架置入术。了解包括激光和电液压碎石术在内的先进方法以及针对疑难病例的乳头扩张术也很重要。对于需要进行胆囊切除术的患者，ERCP的时机和必要性也是需要考虑的因素。
