Minimally Invasive Treatment for Cholelithiasis

H. Okamoto
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Abstract

Gallstone disease, cholecysto- and choledocho-lithiasis, is one of the most common digestive diseases. Most patients with symptomatic cholecystolithiasis are recommended to undergo cholecystectomy to alleviate their symptoms like abdominal pain and jaundice. Approximately 10–20% of patients who undergo cholecystectomy for gallstones have choledocholithiasis. Nowadays, endoscopic and/or laparoscopic approaches are widely accepted as the treatment for patients with gallstone. Patients with cholecystolithiasis are usually treated by laparoscopic cholecystectomy, whereas patients with choledocholithiasis are done by endoscopic sphincterotomy (EST) or laparoscopic common bile duct exploration (LCBDE). Additionally, some cases are treated by biliary reconstruction such as biliary enteric anastomosis. In this chapter, currently available laparoscopic approaches as a minimally invasive surgery are introduced and discussed on the basis of pathogenesis of the gallstone.
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胆石症的微创治疗
胆结石病,即胆囊结石和胆总管结石,是最常见的消化系统疾病之一。大多数有症状的胆囊结石患者建议行胆囊切除术以减轻腹痛、黄疸等症状。大约10-20%因胆结石而行胆囊切除术的患者患有胆总管结石。目前,内镜和/或腹腔镜方法被广泛接受作为胆结石患者的治疗方法。胆囊结石患者通常采用腹腔镜胆囊切除术,而胆总管结石患者则采用内镜下括约肌切开术(EST)或腹腔镜下胆总管探查术(LCBDE)。此外,部分病例采用胆道重建如胆道肠吻合术。在本章中,根据胆结石的发病机制,介绍和讨论了目前可用的腹腔镜微创手术方法。
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Routine and Innovation in Surgical Therapy of Gallstones Minimally Invasive Treatment for Cholelithiasis Infections of Biliary Tract Pathophysiology of Gallstones Acute Alitasic Cholecystitis
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