CAJ | 학술논문

胆石性肠梗阻是胆石症的少见并发症，Bouveret综合征是胆石性肠梗阻的特殊类型，即胆石通过胆肠瘘进入胃肠道，持续嵌顿于近端十二指肠或幽门部而引起胃流出道梗阻。本病多见于老年女性患者。由于临床表现缺乏特异性，加之患者高龄、合并基础疾病、存在延迟诊断，致使并发症与病死率一度维持在较高水平。尽管各种非手术治疗手段扮演着越来越重要的作用，手术仍在治疗中占据主导地位。取出结石、解除梗阻，一期或二期切除胆囊、修补瘘管是手术治疗主要策略。多年来争议的焦点集中在手术方式的选择上。总之，提高对本病的认识，早期正确的诊断和及时有效的治疗措施是改善预后的关键。
담석성장경조시담석증적소견병발증，Bouveret종합정시담석성장경조적특수류형，즉담석통과담장루진입위장도，지속감돈우근단십이지장혹유문부이인기위류출도경조。본병다견우노년녀성환자。유우림상표현결핍특이성，가지환자고령、합병기출질병、존재연지진단，치사병발증여병사솔일도유지재교고수평。진관각충비수술치료수단분연착월래월중요적작용，수술잉재치료중점거주도지위。취출결석、해제경조，일기혹이기절제담낭、수보루관시수술치료주요책략。다년래쟁의적초점집중재수술방식적선택상。총지，제고대본병적인식，조기정학적진단화급시유효적치료조시시개선예후적관건。
Gallstone ileus is a rare complication of cholelithiasis. Bouveret's syndrome is a special variant of gallstone ileus resulting in gastric outlet obstruction. It is caused by a persistently impacted gallstone passing in the proximal duodenum or pylorus through a cholecystoenteric fistula. It occurs most commonly in elderly female patients. The morbidity and mortality rates once remained at a high level because of the unspecific clinical manifestations, patient's advanced age, basic comorbidities and delayed diagnosis. Surgery still maintains a prominent position, even though non-operative procedures have an increasing role in treatment. Remove the stones, relieve obstruction followed by cholecystectomy and fistula repair as a 1- or 2-stage procedure is the main surgical strategy. For many years, controversies exist in the choice of surgical approach. Anyway, highlighting the awareness of this syndrome, early correct diagnosis and timely effective treatment is the key to improving prognosis.