Weis H J
Fortschr Med. 1980 Sep 4;98(33):1235-9.
The indications for gallstone dissolution have to consider different factors of the gallbladder and its stones. The bladder must be visualized in an i.v. cholecystogram and should well contract on meal. The gallstones should not be calcified and their diameter should not be greater than 2 cm. Dissolution is only possible for cholesterol gallstones. Until today their negative presentation on x-ray is the most important hint at their composition, but pigment stones often are negative on x-ray, too. This unsatisfactory diagnosis of cholesterol gallstones in vivo restricts the success rate of gallstone dissolution to approximately 70%, when the other factors of the treatment are observed. A comparison of cost of dissolution and operation shows that despite the restricted success rate dissolution of gallstones is also justified when indications are well observed.
胆结石溶解的适应证必须考虑胆囊及其结石的不同因素。胆囊必须在静脉胆囊造影中显影,并且在进食时应能良好收缩。胆结石不应钙化,其直径不应大于2厘米。仅胆固醇性胆结石才可能溶解。直到现在,它们在X射线下的阴性表现是其成分的最重要提示,但色素结石在X射线下通常也呈阴性。这种体内胆固醇性胆结石诊断的不令人满意,将胆结石溶解的成功率限制在约70%,前提是遵守治疗的其他因素。溶解和手术成本的比较表明,尽管成功率有限,但在严格遵守适应证的情况下,胆结石溶解也是合理的。