Bournemouth Digestive Diseases Centre, Royal Bournemouth and Christchurch NHS Hospital Trust, Bournemouth, UK.
HPB Service, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Gut. 2017 May;66(5):765-782. doi: 10.1136/gutjnl-2016-312317. Epub 2017 Jan 25.
Common bile duct stones (CBDS) are estimated to be present in 10-20% of individuals with symptomatic gallstones. They can result in a number of health problems, including pain, jaundice, infection and acute pancreatitis. A variety of imaging modalities can be employed to identify the condition, while management of confirmed cases of CBDS may involve endoscopic retrograde cholangiopancreatography, surgery and radiological methods of stone extraction. Clinicians are therefore confronted with a number of potentially valid options to diagnose and treat individuals with suspected CBDS. The British Society of Gastroenterology first published a guideline on the management of CBDS in 2008. Since then a number of developments in management have occurred along with further systematic reviews of the available evidence. The following recommendations reflect these changes and provide updated guidance to healthcare professionals who are involved in the care of adult patients with suspected or proven CBDS. It is not a protocol and the recommendations contained within should not replace individual clinical judgement.
胆总管结石(CBDS)估计存在于 10-20%有症状的胆囊结石患者中。它们可导致多种健康问题,包括疼痛、黄疸、感染和急性胰腺炎。多种成像方式可用于识别这种情况,而 CBDS 确诊病例的治疗可能涉及内镜逆行胰胆管造影、手术和放射学取石方法。因此,临床医生面临着许多潜在有效的诊断和治疗疑似 CBDS 患者的选择。英国胃肠病学会于 2008 年首次发布了 CBDS 管理指南。此后,在管理方面出现了一些进展,并对现有证据进行了进一步的系统评价。以下建议反映了这些变化,并为参与疑似或确诊 CBDS 成年患者护理的医疗保健专业人员提供了更新的指导。这不是一个方案,其中包含的建议不应替代个体临床判断。