Malè P J, Meyer P
Schweiz Med Wochenschr. 1986 Aug 5;116(31-32):1040-4.
Western life-style and an older population make gallstones, "silent" or otherwise, a commoner problem than in the past. Whilst symptomatic gallstones should be treated surgically, "silent" gallstones usually remain that way and do not require prophylactic cholecystectomy. However, if common bile duct stones have been demonstrated or only suspected, surgery is the treatment of choice even in the absence of symptoms. Surgical mortality is very low at less than 1% for cholecystectomy and bile duct exploration. These figures apply to a population of whom half are over 70 years of age. Chemical dissolution of cholesterol gallstones is only of use in a small minority of patients, notably those at high surgical risk or who refuse surgery. Endoscopic sphincterotomy is useful as primary treatment in cases of cholangitis and gallstone-associated pancreatitis, and often allows removal of bile duct stones in inoperable patients.
西方的生活方式以及人口老龄化使得胆结石，无论有无症状，都比过去更为常见。有症状的胆结石应接受手术治疗，而“无症状”胆结石通常会一直保持这种状态，无需预防性胆囊切除术。然而，如果已证实或仅怀疑存在胆总管结石，即使没有症状，手术也是首选的治疗方法。胆囊切除术和胆管探查术的手术死亡率非常低，低于1%。这些数据适用于一半年龄超过70岁的人群。胆固醇性胆结石的化学溶解仅对少数患者有用，特别是那些手术风险高或拒绝手术的患者。内镜括约肌切开术在胆管炎和胆结石相关性胰腺炎的病例中作为主要治疗方法很有用，并且常常能使无法手术的患者取出胆管结石。
