引用本文:范海军,田大广(综述),魏晓平(审校).复发性肝内胆管结石病因机制及外科治疗研究进展[J].中国临床新医学,2019,12(9):1029-1034.
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复发性肝内胆管结石病因机制及外科治疗研究进展
范海军,田大广(综述),魏晓平(审校)
650101 云南,昆明医科大学第二附属医院肝胆胰外科一病区
摘要:
[摘要] 肝内胆管结石(intrahepatic bile duct stones,IBDS)是肝胆外科的常见病,其病因复杂,治疗难度大,术后复发率高、并发症多,严重影响患者的生活质量。目前临床上IBDS的复发机制研究尚未完全清楚,可能与细菌寄生虫感染、胆管炎反复发作和胆汁淤滞、遗传环境与饮食代谢及初次治疗方式及时机选择等有关。随着现代医疗技术发展,IBDS的各种治疗方式层出不穷,精准肝切除术、经皮肝胆道镜取石术(PTCS)、各种内镜及碎石技术微创外科等发展迅速。该文主要对IBDS复发的病因机制及其治疗研究进展作一综述,旨在为临床治疗及IBDS的术后复发预防提供一定依据,以期减轻患者病痛并提高其生活质量。
关键词:  肝内胆管结石  复发  病因学  精准肝切术  经皮肝胆道镜取石术
DOI:10.3969/j.issn.1674-3806.2019.09.27
分类号:R 657.42
基金项目:
Advances in etiological mechanism and surgical treatment of recurrent intrahepatic bile duct stones
FAN Hai-jun, TIAN Da-guang, WEI Xiao-ping
The First Department of Hepatopancreatobiliary Surgery, the Second Affiliated Hospital of Kunming Medical University, Yunnan 650101,China
Abstract:
[Abstract] Intrahepatic bile duct stones(IBDS) is one of the common diseases in hepatobiliary surgery. The causes of IBDS are complex and its treatment is difficult. IBDS has many complications and high incidence of postoperative recurrence, seriously affecting the quality of the patients′ life. Currently, the recurrence mechanism of IBDS in clinical practice is not completely clear, and may be related to bacterial and parasitic infections, recurrent cholangitis and cholestasis, genetic environment and dietary metabolism, and initial treatment mode and timing selection. With the development of modern medical technology, various treatment methods have emerged one after another. Precise hepatectomy, percutaneous hepatic choledochoscopy(PTCS), various endoscopic and lithotriptic minimally invasive techniques have developed rapidly. In this paper, the etiological mechanism of recurrence of hepatolithiasis and its treatment progress are summarized, so as to provide some basis for clinical treatment and prevention of recurrence of IBDS after operation and to alleviate the patients′ pain and improve their quality of life.
Key words:  Intrahepatic bile duct stones(IBDS)  Recurrence  Etiology  Precise hepatectomy  Percutaneous hepatic choledochoscopy(PTCS)