复杂性肝内胆管结石的治疗策略

Treatment Strategies for Complex Intrahepatic Bile Duct Stone

摘要: 胆内胆管结石病是一种常见的临床疾病，尤其在合并门静脉高压、合并肝内胆管癌、结石分布于肝脏两侧、多次手术后再发结石以及合并胆管狭窄的情况下，治疗更加复杂。本综述旨在总结复杂肝内胆管结石病治疗的现状和进展。通过回顾相关文献，讨论各种治疗方法，包括外科手术、内镜治疗、介入治疗、及药物治疗等的优缺点，探讨针对合并症的治疗策略，以及针对多次手术后再发结石的处理方法。同时，对目前治疗中存在的问题和展望未来研究方向进行讨论，以期为临床医生提供更为全面和深入的治疗参考，从而改善患者的预后和生活质量。

Abstract: Hepatolithiasis is a common clinical disease, especially when complicated by portal hypertension, concurrent intrahepatic bile duct carcinoma, bilateral distribution of stones within the liver, recur-rent stones after multiple surgeries, and concurrent biliary stricture, making the treatment more intricate. This review aims to summarize the current status and advancements in the treatment of complex intrahepatic bile duct stones. Through a comprehensive review of relevant literature, var-ious treatment modalities are discussed, including surgical procedures, endoscopic interventions, interventional treatments, and pharmacotherapy, highlighting their advantages and limitations. The review explores treatment strategies for associated complications and addresses approaches for managing recurrent stones following multiple surgeries. Simultaneously, it discusses current challenges in treatment and outlines future research directions, intending to provide clinicians with a more comprehensive and in-depth therapeutic reference, ultimately enhancing patient prognosis and quality of life.