胆囊结石处理的临床决策：从适应证到术式选择的再探索

Clinical decision-making in the management of gallstones: a re-exploration from indication to surgical options

摘要:

胆囊结石是胆道外科诊治的主要良性疾病，随着医学技术的发展和人们健康意识的提高，其检出率逐年提高，其中大部分为无症状或轻症胆囊结石。目前，胆囊结石的临床治疗主要为观察、保守治疗或行手术治疗（腹腔镜下胆囊切除术）等，但对于该类患者的临床处理尚存一定争议。主要是对于无症状或轻症胆囊结石，如何把握胆囊切除的适应证是学术界及临床一线争论的焦点。本文梳理了国内外相关文献，围绕胆囊结石的临床处理、胆囊切除适应证的把握等有关争议，从多个方面对其进行阐述。

Abstract:

Gallstones are the primary benign disease diagnosed and treated in biliary surgery. With the development of medical technology and the increasing awareness of health among the population, the detection rate of gallstones has been increasing annually, with the majority being asymptomatic or mild cases. Currently, the clinical treatment of gallstones mainly includes observation, conservative, or surgical treatment (laparoscopic cholecystectomy). However, there remains some controversy regarding the clinical management of these patients. For asymptomatic or mild gallstones, the main point of contention in both academic and clinical settings is how to determine the indications for cholecystectomy. This article reviews relevant literature from both domestic and international sources, addressing the controversies surrounding the clinical management of gallstones and the determination of indications for cholecystectomy, and elaborates on these issues from multiple perspectives.