Strunk E, Kautz G, Clemens M, van Husen N
Helv Chir Acta. 1979 Feb;45(6):817-25.
The number of cases in bile duct surgery has continuously increased since second world war. Correcting operation is necessary in 5 to 7% after cholecystectomy. Since 1973 more and more the endoscopic treatment takes place of surgery. Typical complications can be divided into two groups belonging to their manifestation. Early complications are due to an insufficient intraoperative diagnosis or injuries of bile tract. Late complications comprehend successive development of duct stenosis and cholangitis. The therapeutic possibilities of endoscopic papillotomy are directed only to the papilla and near-by sections of the choledochus, while surgical treatment is due to the more difficult performance of iatrogenic lesions. The indications to each method are shown and discussed by 138 surgical and 714 endoscopic treatments.
自第二次世界大战以来,胆管手术的病例数持续增加。胆囊切除术后,5%至7%的患者需要进行矫正手术。自1973年以来,越来越多的内镜治疗取代了手术。典型并发症可根据其表现分为两组。早期并发症是由于术中诊断不足或胆道损伤所致。晚期并发症包括胆管狭窄和胆管炎的相继发展。内镜乳头切开术的治疗可能性仅针对乳头和胆总管附近区域,而手术治疗则是由于医源性损伤的操作难度较大。通过138例手术治疗和714例内镜治疗展示并讨论了每种方法的适应症。