目前对无症状胆道结石的治疗策略
Ryunosuke Hakuta1, Ryota Nakabayashi1, Yutaka Shimamatsu1
1Department of Internal Medicine, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.
Expert review of gastroenterology & hepatology
|November 10, 2025
概括
无症状的胆道结石很常见,但对内镜逆行胆道细胞造影 (ERCP) 的证据有限. 由于自发的石头通道潜力,等待和观察策略可能是一个可行的选择.
科学领域:
- 胃肠病学 胃肠病学
- 肝病学 肝病学是一种肝病学.
- 内镜手术 进行内镜手术
背景情况:
- 无症状的胆道结石经常通过成像检测.
- 目前的指导方针建议用于治疗的内镜逆行胆血管细胞造影 (ERCP),但缺乏可靠的结果数据.
研究的目的:
- 审查ERCP对无症状胆道结石的临床结果和技术方面.
- 评估ERCP和等待策略的短期和长期结果.
- 提出基于证据的治疗策略.
主要方法:
- 在PubMed的文献搜索到2025年3月.
- 关于ERCP的临床结果和技术建议的综合证据.
- 分析了长期结果,包括自发石头通道和等待方法的并发症.
主要成果:
- 无症状胆道结石的ERCP具有高ERCP后胰腺炎 (PEP) 的高风险.
- 预防PEP的预防措施包括NSAID,预防性支架和水分.
- 等待和观察策略是一个潜在的选择,考虑到自发的石头通道率.
结论:
- 无症状胆道结石的ERCP需要对PEP进行谨慎的风险减轻.
- 等待和观察策略是一个可行的替代方案,平衡风险和收益.
- 量身定制的治疗策略对于管理无症状胆道结石至关重要.
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