Gupta Varsha, Abhinav Abhinav, Vuthaluru Srineil, Kalra Shivam, Bhalla Akshita, Rao Abhinav K, Goyal Manjeet K, Vuthaluru Ashita R
Anesthesiology, Maharishi Markandeshwar Institute of Medical Sciences and Research, Ambala, IND.
Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, IND.
Cureus. 2024 Jun 16;16(6):e62500. doi: 10.7759/cureus.62500. eCollection 2024 Jun.
Gallstones, or cholelithiasis, represent a prevalent gastrointestinal disorder characterized by the formation of calculi within the gallbladder. This review aims to provide a comprehensive analysis of the complications associated with gallstones, with a focus on their pathophysiology, clinical manifestations, diagnostic methodologies, and management strategies. Gallstone-related complications encompass a broad spectrum, including biliary colic, acute cholecystitis, choledocholithiasis, acute pancreatitis, and cholangitis. The pathogenesis of these complications primarily involves biliary obstruction and subsequent infection, leading to significant morbidity and potential mortality. Diagnostic evaluation of gallstone complications employs various imaging techniques, such as ultrasonography, magnetic resonance cholangiopancreatography (MRCP), and endoscopic retrograde cholangiopancreatography (ERCP), each with distinct advantages and limitations. Therapeutic approaches are discussed, ranging from conservative management with pharmacotherapy and bile acid dissolution agents to interventional procedures like extracorporeal shock wave lithotripsy (ESWL) and percutaneous cholecystostomy. Surgical management, particularly laparoscopic cholecystectomy, remains the gold standard for definitive treatment. Additionally, advancements in endoscopic techniques, including endoscopic sphincterotomy (EST) and cholangioscopy, are highlighted. This review synthesizes current research findings and clinical guidelines, aiming to enhance the understanding and management of gallstone-related complications among healthcare professionals, thereby improving patient outcomes and reducing the burden of this common ailment.
胆结石，即胆石症，是一种常见的胃肠道疾病，其特征是在胆囊内形成结石。本综述旨在全面分析与胆结石相关的并发症，重点关注其病理生理学、临床表现、诊断方法和管理策略。与胆结石相关的并发症范围广泛，包括胆绞痛、急性胆囊炎、胆总管结石、急性胰腺炎和胆管炎。这些并发症的发病机制主要涉及胆道梗阻和随后的感染，导致显著的发病率和潜在的死亡率。胆结石并发症的诊断评估采用多种成像技术，如超声检查、磁共振胰胆管造影（MRCP）和内镜逆行胰胆管造影（ERCP），每种技术都有其独特的优缺点。讨论了治疗方法，从药物治疗和胆汁酸溶解剂的保守治疗到体外冲击波碎石术（ESWL）和经皮胆囊造瘘术等介入手术。手术治疗，尤其是腹腔镜胆囊切除术，仍然是确定性治疗的金标准。此外，还强调了内镜技术的进展，包括内镜括约肌切开术（EST）和胆管镜检查。本综述综合了当前的研究结果和临床指南，旨在提高医疗专业人员对胆结石相关并发症的认识和管理，从而改善患者预后并减轻这种常见疾病的负担。
