CAJ | 학술논문

肝胆管结石病是腹部外科常见病,虽然其发病率呈下降趋势,但我国是该病的高发地区,仍有大量的肝胆管结石病患者.该病具有病情复杂、病变广泛、术后易复发以及术后并发症多等特点,严重影响患者的身心健康和生命质量.该病的诊断与治疗仍是一个极富挑战的外科难题.《肝胆管结石病诊断治疗指南》以及《腹腔镜治疗肝胆管结石病的专家共识(2013版)》制订了肝胆管结石病简明实用的分型系统,并提出了“去除病灶、取尽结石、矫正狭窄、通畅引流、防止复发”的指导方针,明确了以腹腔镜为代表的微创技术在肝胆管结石病中的应用价值,对我国肝胆管结石病的规范化诊断与治疗起到了巨大的推动作用.近年来的循证医学证据更进一步证实了解剖性肝切除术在肝胆管结石病治疗中的重要性.随着腹腔镜技术的迅猛进展,以腹腔镜肝切除术为主导的多镜联合治疗模式也日趋成熟.精准外科理念的兴起更为肝胆管结石病的规范化诊断与治疗注入了新的活力.
간담관결석병시복부외과상견병,수연기발병솔정하강추세,단아국시해병적고발지구,잉유대량적간담관결석병환자.해병구유병정복잡、병변엄범、술후역복발이급술후병발증다등특점,엄중영향환자적신심건강화생명질량.해병적진단여치료잉시일개겁부도전적외과난제.《간담관결석병진단치료지남》이급《복강경치료간담관결석병적전가공식(2013판)》제정료간담관결석병간명실용적분형계통,병제출료“거제병조、취진결석、교정협착、통창인류、방지복발”적지도방침,명학료이복강경위대표적미창기술재간담관결석병중적응용개치,대아국간담관결석병적규범화진단여치료기도료거대적추동작용.근년래적순증의학증거경진일보증실료해부성간절제술재간담관결석병치료중적중요성.수착복강경기술적신맹진전,이복강경간절제술위주도적다경연합치료모식야일추성숙.정준외과이념적흥기경위간담관결석병적규범화진단여치료주입료신적활력.
Hepatolithiasis is a common disease of abdominal surgery,although its incidence appears to decline,China is still a high incidence area with millions of patients with hepatolithiasis.Because of the complex pathogenesis,progressive development and frequent recurrence,it is seriously affecting physical and mental health of patients and quality of life,as well as difficult to define the diagnosis and select treatment methods for hepatolithiasis.The Guideline of the Diagnosis and Treatments of Hepatolithiasis and the Expert Consensus of the Laparoscopic Treatments of Hepatolithiasis (2013 edition) proposed a concise and practical classification system of the hepatolithiasis and summarized the principles of surgical treatments,which included " resecting the lesions,cleaning the stones,correcting the stricture,recovering the drainage and preventing the recurrence ".Meanwhile,the application of laparoscopic technique in the treatments of bepatolithiasis was proposed,which played an important role to promote the standard diagnosis and treatments of hepatolithiasis in China.Recent years,more and more evidences from evidence-based medicine further proved the importance of the anatomical hepatectomy in the treatments of hepatolithiasis.With the soaring development of laparoscopic surgery,the combination of laparoscopic hepatectomy with the assistance of other endoscopies are applied more and more frequently.The concept of precise surgery also brings new vitality to the standard diagnosis and treatments of the hepatolithiasis.