Vanella Serafino, Baiamonte Mario, Crafa Francesco
Division of General and Surgical Oncology, St. Giuseppe Moscati Hospital, Center of National Excellence and High Specialty, Avellino 83100, Italy.
General and Emergency Surgery Unit, Civico Benfratelli Di Cristina Hospital, Palermo 90121, Italy.
World J Gastrointest Endosc. 2022 Jul 16;14(7):467-470. doi: 10.4253/wjge.v14.i7.467.
Gallstone cholangiopancreatitis is a potentially life-threatening pathology which requires quick intervention involving endoscopists, interventional radiologists, anesthesiologists and surgeons in relation to clinical conditions. Treatment possibilities are varied, especially with current progress in advanced endoscopy, interventional radiology, and minimally invasive surgery. The following treatments are available: endoscopic sphincterotomy (ES) with stone extraction followed by laparoscopic cholecystectomy; simultaneous endoscopic stone extraction with laparoscopic cholecystectomy (rendezvous technique); combined laparoscopic cholecystectomy and common bile duct (CBD) exploration; open CBD exploration; ES post-cholecystectomy; percutaneous placement of biliary drains for unstable patients, followed by percutaneous cholangioscopy; and lithotripsy with different approaches, including a laser and balloon dilation of the sphincter of Oddi. Each technique has its strengths and weaknesses, and there is great discussion in the literature on choosing the ideal approach based on the patient's clinical conditions.
胆石性胆胰炎是一种潜在的危及生命的病症,需要根据临床情况迅速进行干预,涉及内镜医师、介入放射科医生、麻醉师和外科医生。治疗方法多种多样,特别是随着目前先进内镜检查、介入放射学和微创手术的进展。以下是可用的治疗方法:内镜括约肌切开术(ES)联合取石术,随后进行腹腔镜胆囊切除术;腹腔镜胆囊切除术同时进行内镜取石术(会师技术);腹腔镜胆囊切除术联合胆总管(CBD)探查;开放性CBD探查;胆囊切除术后ES;对不稳定患者经皮放置胆道引流管,随后进行经皮胆道镜检查;以及采用不同方法的碎石术,包括激光和Oddi括约肌球囊扩张术。每种技术都有其优缺点,并且文献中对于根据患者临床情况选择理想的治疗方法存在大量讨论。