霍尔多卡尔酸. 霍尔多卡尔酸. 多学科治疗目标. 多学科治疗目标. 过去和现在的过去和现在
概括
胆固醇结石病的治疗已经发展成为一种多学科的方法. 现在对于迁移的石头来说,内镜清除是首选的,而复杂的病例仍然需要手术.
科学领域:
- 胃肠病学 胃肠病学
- 手术创新 在外科创新.
- 胆道疾病 胆道疾病
背景情况:
- 胆病是一种常见的外科病理.
- 在过去的50年里,胆固醇化 (CL) 的治疗方法有了显著的进化.
- 从历史上看,手术是CL的唯一治疗方法.
研究的目的:
- 为了回顾50年来胆固醇结石病治疗的演变.
- 为了比较经典手术与多学科方法的结果.
- 建议在CL中对治疗指示进行分类.
主要方法:
- 对1329名胆固醇胆病患者的回顾性研究.
- 第1组 (1959-1997):有982名患者接受了古典手术治疗.
- 第二组 (1997-2017):347名患者接受了内镜和/或古典手术治疗.
主要成果:
- 在第二组中,76.6%的患者接受了内镜手术,而传统手术的患者比例为23.4%.
- 在第二组,内镜失效率为26.3%.
- 经典手术的阻塞清除失败率为12.3%,往往需要胆管消化性瘤.
结论:
- 综合内镜和手术的多学科方法现在是CL的标准.
- 建议的治疗指示将CL分为"内镜胆固醇","外科胆固醇"和"石质胆固醇".
- 复杂,复杂或复发性CL (2和3类) 可能是内镜清除的禁忌.
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