胆肠吻合术后肝内胆管结石复发机制与治疗的研究进展

Research Progress on the Mechanisms and Treatment of Intrahepatic Bile Duct Stone Recurrence after Choledochoenterostomy

摘要: 肝内胆管结石是一种慢性、易复发的胆道疾病，尤其在胆肠吻合术后，治疗效果常受多种因素影响。尽管影像学技术和手术治疗有所进展，但术后结石复发仍是临床治疗中的重要问题。术后复发率受胆道解剖、胆道动力学异常、胆管狭窄及胆道感染等因素的影响，且复发率随随访时间的延长逐渐增高。本文综述了近年来关于胆肠吻合术后肝内胆管结石复发的机制、危险因素及干预治疗策略，旨在为临床治疗提供参考。未来的研究应着重于术后长期随访，探索复发机制，并结合微创治疗与个性化治疗策略，降低复发率，提高患者的生活质量。

Abstract: Intrahepatic bile duct stones represent a chronic and recurrent biliary disorder, particularly following choledochoenterostomy, where treatment outcomes are frequently influenced by a variety of factors. Despite advancements in imaging technology and surgical treatments, postoperative stone recurrence continues to be a significant challenge in clinical management. The recurrence rate is influenced by factors such as biliary anatomy, abnormalities in biliary dynamics, bile duct strictures, and biliary infections, with the recurrence rate progressively increasing over time with extended follow-up. This review summarizes recent research on the mechanisms, risk factors, and intervention strategies for the recurrence of intrahepatic bile duct stones after choledochoenterostomy, with the goal of providing guidance for clinical treatment. Future research should prioritize long-term postoperative follow-up, explore the underlying mechanisms of recurrence, and incorporate minimally invasive and personalized treatment strategies to reduce recurrence rates and enhance patients’ quality of life.