结石性胆囊炎的个体化治疗

杜前程; 周瀛; 张灵强; 胡陈亮; 樊海宁

doi:10.3969/j.issn.1001-5256.2018.10.042

结石性胆囊炎的个体化治疗

DOI: 10.3969/j.issn.1001-5256.2018.10.042

1. 青海大学研究生院
2. 青海大学附属医院肝胆胰外科

基金项目:

青海省科学技术厅重大科技专项(2016-SF-A5)；

详细信息

中图分类号: R657.41
计量
- 文章访问数: 1930
- HTML全文浏览量: 56
- PDF下载量: 348
- 被引次数: 0
出版历程
- 收稿日期: 2018-04-16
- 出版日期: 2018-10-20

Individualized treatment of calculous cholecystitis

Graduate School, Qinghai University

Research funding:

摘要

摘要: 结石性胆囊炎为临床常见病、多发病,其治疗方法多样,以胆囊切除为主,腹腔镜胆囊切除术一直以来被认为是治疗结石性胆囊炎的"金标准"。然而,因年龄、病情状况、合并症、患者意愿等不同,也可选择药物治疗、经皮经肝胆囊穿刺引流术、保胆取石术等方法。简述了结石性胆囊炎患者的药物治疗、介入治疗、手术治疗的特点,认为可根据不同结石性胆囊炎患者的自身疾病特点选择最佳治疗方案,并提出了针对结石性胆囊炎的"个体化"治疗模式。
- 胆囊结石 /
- 胆囊炎 /
- 药物疗法 /
- 超声检查,介入性 /
- 外科手术 /
- 综述
Abstract: Calculous cholecystitis is a common disease in clinical practice. There are various therapies for this disease, mainly cholecystectomy, and laparoscopic cholecystectomy has always been considered the gold standard for the treatment of calculous cholecystitis. However, medication, percutaneous transhepatic gallbladder drainage, and gallbladder-preserving cholecystolithotomy can be selected based on patient age, conditions, comorbidities, and preference. This article briefly describes the features of medication, interventional treatment, and surgical treatment in patients with calculous cholecystitis and points out that the optimal treatment regimen should be selected based on the features of calculous cholecystitis in each patient. This article also proposes the individualized treatment mode for calculous cholecystitis.
- cholecystolithiasis /
- cholecystitis /
- drug therapy /
- ultrasound interventional /
- surgical procedures, operative /
- review

HTML全文

参考文献(56)

[1]ZHOU BB, WANG XM, ZHANG Q, et al.Association between metabolic syndrome and gallstones[J].J Clin Hepatol, 2017, 33 (5) :880-882. (in Chinese) 周冰冰, 王学梅, 张茜, 等.代谢综合征与胆囊结石的相关性分析[J].临床肝胆病杂志, 2017, 33 (5) :880-882.

[2]SAKORAFAS GH, MILINGOS D, PEROS G.Asymptomatic cholelithiasis:is cholecystectomy really needed?A critical reappraisal 15years after the introduction of laparoscopic cholecystectomy[J].Dig Dis Sci, 2007, 52 (5) :1313-1325.

[3]WEI LJ.Evaluation of clinical efficacy of different medications for acute biliary colic[J].J Clin Hepatol, 2015, 31 (10) :1615-1617. (in Chinese) 魏路佳.不同药物治疗急性胆绞痛的效果及安全性比较[J].临床肝胆病杂志, 2015, 31 (10) :1615-1617.

[4]ALTMAN R, BOSCH B, BRUNE K, et al.Advances in NSAID development:evolution of diclofenac products using pharmaceutical technology[J].Drugs, 2015, 75 (8) :859-877.

[5]ZHOU ML, JIA WR, WANG JT, et al.Effect of electroacupuncture at"Yanglingquan" (GB34) acupoint on white blood cell count and gallbladder wall thickness in rabbits with acute cholecystitis[J].Zhen Ci Yan Jiu, 2015, 40 (3) :233-237.

[6]FENG LS, GU CF, YU LH, et al.Pain-relieving effects of acupuncture in treating 260 patients with acute cholecystalgia[J].JYunnan Coll Tradit Chin Med, 2014, 37 (1) :43-44. (in Chinese) 冯林松, 顾春飞, 郁林海, 等.针刺对260例急性胆绞痛镇痛作用的疗效观察[J].云南中医学院学报, 2014, 37 (1) :43-44.

[7]LEE JK, KANG HW, KIM JH, et al.Effects of Korean red ginseng as an adjuvant to bile acids in medical dissolution therapy for gallstones:a prospective, randomized, controlled, double-blind pilot trial[J].Food Funct, 2013, 4 (1) :116-120.

[8]QIAO T, MA RH, LUO XB, et al.The systematic classification of gallbladder stones[J].PLo S One, 2013, 8 (10) :e74887.

[9]BJRKHEM-BERGMAN L, NYLN H, ERIKSSON M, et al.Effect of statin treatment on plasma 4β-hydroxycholesterol concentrations[J].Basic Clin Pharmacol Toxicol, 2016, 118 (6) :499-502.

[10]YU DD, ANDRALI SS, LI H, et al.Novel FXR (farnesoid X receptor) modulators:Potential therapies for cholesterol gallstone disease[J].Bioorg Med Chem, 2016, 24 (18) :3986-3993.

[11] GUARINO MP, COCCA S, ALTOMARE A, et al.Ursodeoxycholic acid therapy in gallbladder disease, a story not yet completed[J].World J Gastroenterol, 2013, 19 (31) :5029-5034.

[12]WANG HH, PORTINCASA P, de BARI O, et al.Prevention of cholesterol gallstones by inhibiting hepatic biosynthesis and intestinal absorption of cholesterol[J].Eur J Clin Invest, 2013, 43 (4) :413-426.

[13]OZKOL HU, CALKA O, DULGER AC, et al.Ursodeoxycholic acid induced generalized fixed drug eruption[J].Cutan Ocul Toxicol, 2014, 33 (3) :256-258.

[14]GUARINO MP, COCCA S, ALTOMARE A, et al.Ursodeoxycholic acid therapy in gallbladder disease, a story not yet completed[J].World J Gastroenterol, 2013, 19 (31) :5029.

[15]CASTRO-TORRES IG, de JESUS CARDENAS-VAZQUEZ R, VELAZQUEZ-GONZALEZ C, et al.Future therapeutic targets for the treatment and prevention of cholesterol gallstones[J].Eur JPharmacol, 2015, 765:366-374.

[16]AHMED MH, HAMAD MA, ROUTH C, et al.Statins as potential treatment for cholesterol gallstones:an attempt to understand the underlying mechanism of actions[J].Expert Opin Pharmacother, 2011, 12 (17) :2673-2681.

[17]JOHNSON TA, PFEFFER SR.Ezetimibe-sensitive cholesterol uptake by NPC1L1 protein does not require endocytosis[J].Mol Biol Cell, 2016, 27 (11) :1845-1852.

[18]GAO Q, HUANG C, SUN B, et al.Fabrication and characterization of metal stent coating with drug-loaded nanofiber film for gallstone dissolution[J].J Biomater Appl, 2016, 31 (5) :784-796.

[19]MIYAZAKI M, SHIBUYA K, TOKUE H, et al.Percutaneous transhepatic biliary drainage assisted by real-time virtual sonography:a retrospective study[J].BMC Gastroenterology, 2013, 13 (1) :127.

[20]GULAYA K, DESAI SS, SATO K.Percutaneous cholecystostomy:evidence-based current clinical practice[J].Semin Intervent Radiol, 2016, 33 (4) :291-296.

[21]YI-YUNG YU E, YANG FS, CHIU YJ, et al.Late onset of biliopleural fistula following percutaneous transhepatic biliary drainage:a case report[J].Biomedicine (Taipei) , 2018, 8 (1) :6.

[22]IHAMA Y, FUKAZAWA M, NINOMIYA K, et al.Peritoneal bleeding due to percutaneous transhepatic gallbladder drainage:An autopsy report[J].World J Hepatol, 2012, 4 (10) :288-290.

[23]NI Q, CHEN D, XU R, et al.The efficacy of percutaneous transhepatic gallbladder drainage on acute cholecystitis in high-risk elderly patients based on the Tokyo guidelines:A retrospective case-control study[J].Medicine (Baltimore) , 2015, 94 (34) :e1442.

[24]NA BG, YOO YS, MUN SP, et al.The safety and efficacy of percutaneous transhepatic gallbladder drainage in elderly patients with acute cholecystitis before laparoscopic cholecystectomy[J].Ann Surg Treat Res, 2015, 89 (2) :68-73.

[25]QI JA, LI ZF, WANG ZD, et al.Application of percutaneous transhepatic gallbladder drainage for acute calculous cholecystitis in special population[J/CD].Chin J Hepat Surg:Electronic Edition, 2018, 7 (1) :30-34. (in Chinese) 祁军安, 李宗芳, 王志东, 等.经皮经肝胆囊穿刺引流术在特殊人群急性结石性胆囊炎治疗中的应用[J/CD].中华肝脏外科手术学电子杂志, 2018, 7 (1) :30-34.

[26]CHOI JW, PARK SH, CHOI SY, et al.Comparison of clinical result between early laparoscopic cholecystectomy and delayed laparoscopic cholecystectomy after percutaneous transhepatic gallbladder drainage for patients with complicated acute cholecystitis[J].Korean J Hepatobiliary Pancreat Surg, 2012, 16 (4) :147-153.

[27]YU WK, LI WQ, LI N, et al.Mononuclear histocompatibility leukocyte antigen-DR expression in the early phase of acute pancreatitis[J].Pancreatology, 2004, 4 (3-4) :233-243.

[28]XIE MP, WANG J.Research status of acute cholecystitis in elderly patients[J].Trauma Crit Med, 2016, 4 (1) :62-64. (in Chinese) 解民鹏, 王静.高龄患者急性胆囊炎研究现状[J].创伤与急危重病医学, 2016, 4 (1) :62-64.

[29]WIDMER J, ALVAREZ P, SHARAIHA RZ, et al.Endoscopic gallbladder drainage for acute cholecystitis[J].Clin Endosc, 2015, 48 (5) :411-420.

[30]MAEKAWA S, NOMURA R, MURASE T, et al.Endoscopic gallbladder stenting for acute cholecystitis:a retrospective study of46elderly patients aged 65 years or older[J].BMC Gastroenterol, 2013, 13:65.

[31]KAMATA K, TAKENAKA M, KITANO M, et al.Endoscopic ultrasound-guided gallbladder drainage for acute cholecystitis:Long-term outcomes after removal of a self-expandable metal stent[J].World J Gastroenterol, 2017, 23 (4) :661-667.

[32]LU J, CHENG Y, XIONG XZ, et al.Two-stage vs single-stage management for concomitant gallstones and common bile duct stones[J].World J Gastroenterol, 2012, 18 (24) :3156-3166.

[33]SUNADA F, MORIMOTO N, TSUKUI M, et al.The rendezvous technique involving insertion of a guidewire in a percutaneous transhepatic gallbladder drainage tube for biliary access in a case of difficult biliary cannulation[J].J Rural Med, 2017, 12 (1) :46-49.

[34]HE XW.Application value of ultrasound-guided percutaneous transhepatic cholangial drainage in the treatment of obstructive jaundice[J].China Prac Med, 2016, 11 (33) :73-75. (in Chinese) 何雄伟.超声引导下经皮肝胆道穿刺引流术治疗梗阻性黄疸的应用价值[J].中国实用医药, 2016, 11 (33) :73-75.

[35]XIA Q, ZHOU XF, FAN XX, et al.Related factors analysis of biliary tract infections after percutaneous transhepatic cholangial drainage in the patients with obstructive jaundice[J].Chin J Nosocomiol, 2017, 27 (17) :3960-3963. (in Chinese) 夏卿, 周新锋, 范晓翔, 等.梗阻性黄疸患者经皮经肝胆道引流术后胆道感染相关因素研究[J].中华医院感染学杂志, 2017, 27 (17) :3960-3963.

[36]INOUE K, UENO T, NISHINA O, et al.Optimal timing of cholecystectomy after percutaneous gallbladder drainage for severe cholecystitis[J].BMC Gastroenterol, 2017, 17 (1) :71.

[37]JUNG BH, PARK JI.Impact of scheduled laparoscopic cholecystectomy in patients with acute cholecystitis, following percutaneous transhepatic gallbladder drainage[J].Ann Hepatobiliary Pancreat Surg, 2017, 21 (1) :21-29.

[38]LEE R, HA H, HAN YS, et al.Percutaneous transhepatic gallbladder drainage followed by elective laparoscopic cholecystectomy for patients with moderate to severe acute cholecystitis[J].Medicine (Baltimore) , 2017, 96 (44) :e8533.

[39]TAN YY, ZHAO G, WANG D, et al.A new strategy of minimally invasive surgery for cholecystolithiasis:calculi removal and gallbladder preservation[J].Dig Surg, 2013, 30 (4-6) :466-471.

[40]ZHANG Y, PENG J, LI X, et al.Endoscopic-laparoscopic cholecystolithotomy in treatment of cholecystolithiasis compared with traditional laparoscopic cholecystectomy[J].Surg Laparosc Endosc Percutan Tech, 2016, 26 (5) :377-380.

[41]LI Q F, XU X, GE X.Gallstone recurrence after minimally-invasive cholecystolithotomy with gallbladder reservation:a follow-up of 720 cases[J].Eur Rev Med Pharmacol Sci, 2015, 19 (8) :1403-1406.

[42]LI QD, CHEN GB, LIU ZG, et al.A comparative study of curative effect between cholecystolithotomy with gallbladder reservation by laparoscopy and choledochoscope and laparoscopic cholecystectomy in patients with cholecystolithiasis[J].Chin J Gen Prac, 2017, 15 (4) :565-567. (in Chinese) 李巧登, 陈光彬, 刘志刚, 等.腹腔镜联合胆道镜保胆取石术和腹腔镜胆囊切除术治疗胆囊结石的疗效对比[J].中华全科医学, 2017, 15 (4) :565-567.

[43]GAO DK, WEI SH, LI W, et al.Totally laparoscopic gallbladder-preserving surgery:A minimally invasive and favorable approach for cholelithiasis[J].Exp Ther Med, 2015, 9 (2) :395-398.

[44]CHUANG SH, LIN CS.Single-incision laparoscopic surgery for biliary tract disease[J].World J Gastroenterol, 2016, 22 (2) :736-747.

[45]EVERS L, BOUVY N, BRANJE D, et al.Single-incision laparoscopic cholecystectomy versus conventional four-port laparoscopic cholecystectomy:A systematic review and meta-analysis[J].Surg Endosc, 2017, 31 (9) :3437-3448.

[46]TAN X, WANG G, TANG Y, et al.Minilaparoscopic versus single incision cholecystectomy for the treatment of cholecystolithiasis:a meta-analysis and systematic review[J].BMC Surg, 2017, 17 (1) :91.

[47]SHANG PZ.Guiding significance to ensure security of laparoscopic cholecystectomy by localization by imaginary clock for ampulla of gallbladder[J/CD].Chin J Oper Proc Gen Surg:Electronic Version, 2018, 12 (1) :15-20. (in Chinese) 尚培中.胆囊壶腹钟表定位法对保障腹腔镜胆囊切除安全性的指导意义[J/CD].中华普外科手术学杂志:电子版, 2018, 12 (1) :15-20.

[48]KIM EY, LEE SH, LEE JS, et al.Laparoscopic CBD exploration using a V-shaped choledochotomy[J].BMC Surg, 2015, 15 (1) :1-6.

[49]ZHANG WJ, XU GF, HUANG Q, et al.Treatment of gallbladder stone with common bile duct stones in the laparoscopic era[J].BMC Surg, 2015, 15 (1) :7.

[50]XIA HT, LIU Y, JIANG H, et al.A novel laparoscopic transcystic approach using an ultrathin choledochoscope and holmium laser lithotripsy in the management of cholecystocholedocholithiasis:An appraisal of their safety and efficacy[J].Am J Surg, 2018, 215 (4) :631-635.

[51]SHIN M, CHOI N, YOO Y, et al.Clinical outcomes of subtotal cholecystectomy performed for difficult cholecystectomy[J].Ann Surg Treat Res, 2016, 91 (5) :226-232.

[52]STROMBERG J, HAMMARQVIST F, SADR-AZODI O, et al.Cholecystectomy in patients with liver cirrhosis[J].Gastroenterol Res Pract, 2015, 2015 (3) :1-6.

[53]LIAO ZF, LI J, XIE J, et al.Timing of laparoscopic cholecystectomy in treatment of biliary pancreatitis[J].Suzhou Univ J Med Sci, 2017, 27 (6) :533-535. (in Chinese) 廖作富, 李军, 谢江, 等.腹腔镜胆囊切除术治疗胆源性胰腺炎的时机分析[J].江苏大学学报:医学版, 2017, 27 (6) :533-535.

[54]POHLEN U, FELLER A, HOLMER C.Transvaginal hybrid NOTES cholecystectomy:A single-centre long-term experience on sexual function[J].World J Surg, 2018, 42 (7) :1960-1964.

[55]YAO BZ, LI L, JIANG M, et al.Refractory chyle leakage after laparoscopic cholecystectomy for gallstone disease:A case report and literature review[J].Medicine (Baltimore) , 2018, 97 (2) :e9604.

[56]XIONG J, WANG Y, HUANG H, et al.Systematic review and meta-analysis:Cholecystectomy and the risk of cholangiocarcinoma[J].Oncotarget, 2017, 8 (35) :59648-59657.

施引文献

资源附件(0)

访问统计