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成人无并发症胆石病

Author
Salam F Zakko, MD, FACP
Section Editor
Sanjiv Chopra, MD, MACP
Deputy Editor
Anne C Travis, MD, MSc, FACG, AGAF

引言

胆石常见，尤其是在西方人群中(表 1)。在美国，胆石可见于约6%的男性以及9%的女性。大多数胆石患者终其一生都没有症状。当胆石开始引发症状，被称为胆石病。无并发症胆石病是指胆囊结石引起胆绞痛，但不伴急性胆囊炎、胆管炎或胆石性胰腺炎等并发症。

很难明确患者的上消化道症状是否为影像学检查到的胆石引起。在普通人群中，虽然胆石和上消化道症状很常见，但是这二者并不总是相关。对无并发症胆石病与其他疾病中偶然发现的胆石进行鉴别极为重要，因为胆囊切除术对有症状的胆石往往能治愈，但也使那些偶发胆石的患者承受不必要的风险，延误了对该症状真实病因的适当治疗，并导致不必要的医疗费用。

本专题将总结无并发症胆石病。胆石流行病学、危险因素、偶然发现胆石患者的处理方法、妊娠期妇女胆石病，以及胆石病并发症将单独讨论。 (参见“胆石症的流行病学和危险因素”和“意外发现胆结石的概述”和“妊娠期胆石症”和“急性胆囊炎的发病机制、临床特征和诊断”和“急性胰腺炎的病因”，关于‘胆石’一节和“急性胆管炎”和“胆总管结石：临床表现、诊断和处理”)

接下来的讨论与英国国家卫生与保健评价研究院的指南基本一致[1]。

患者分类

当考虑胆石病时，我们发现将患者分为如下临床组是有帮助的：

                                         

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Literature review current through: 2017-06 . | This topic last updated: 2017-02-28.
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