Maruf M, Baev S
Khirurgiia (Sofiia). 1998;51(1):18-21.
The diagnostic approach to 227 patients presenting lithiasis of the extrahepatic biliary ducts is discussed. All patients are diagnosed in the second surgical department of the University Aleksandrovska Hospital over an eleven-year period on the ground of complex examinations, including: clinical, laboratory and instrumental (echography, endoscopic retrograde cholangiopancreatography, cholangiography, computerized tomography) study. As shown by the clinical data analysis, the basic symptoms are pain--in 221 cases (97.35%), jaundice--128 (56.38%), accompanied in most of them by dyspeptic complaints, and in a minor part--by cholangitis manifestations. Of the laboratory data, the most commonly met with are the abnormally increased values of serum bilirubin, alkaline phosphatase, liver tests etc. Of the instrumental methods echography is first and foremost used in the preoperative period, supplemented in certain cases with other methods. Intraoperatively, cholangiography is routinely used for concrement detection.
本文讨论了对227例肝外胆管结石患者的诊断方法。所有患者均在亚历山德罗斯卡大学医院第二外科接受了为期11年的诊断，诊断依据包括综合检查，如临床、实验室和仪器检查（超声检查、内镜逆行胰胆管造影、胆管造影、计算机断层扫描）。临床数据分析显示，主要症状为疼痛——221例（97.35%），黄疸——128例（56.38%），大多数患者伴有消化不良症状，少数患者伴有胆管炎表现。在实验室检查数据中，最常见的是血清胆红素、碱性磷酸酶、肝功能检查等异常升高。在仪器检查方法中，超声检查首先在术前使用，某些情况下辅以其他方法。术中常规使用胆管造影来检测结石。
