胆石症(胆结石)

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最后审阅: 1 Nov 2024
最后更新: 22 Apr 2024

小结

定义

病史和体格检查

关键诊断因素

  • 右上腹或者上腹部疼痛(通常持续 >30 分钟)
  • 存在的危险因素
完整详情

其他诊断因素

  • 餐后痛
  • 右上象限或上腹部压痛
  • 恶心
  • 黄疸
完整详情

危险因素

  • 年龄增长
  • 女性
  • 肥胖、糖尿病和代谢综合征
  • 胆石症家族史
  • 基因突变
  • 妊娠/外源性雌激素
  • 非酒精性脂肪肝病
  • 长时间的饥饿或者体重短期内快速下降
  • 全胃肠外营养 (TPN)
  • 药物治疗
  • 回肠末端疾病或者切除
  • 血红蛋白病
  • 拉丁美洲和美国土著人
  • 饮食及生活方式
  • 胆囊幽门螺杆菌感染
完整详情

诊断性检查

首要检查

  • 腹部超声
  • 血清肝功能检查
  • 全血细胞计数 (FBC)
  • 血清脂肪酶或者淀粉酶
完整详情

需考虑的检查

  • 磁共振胰胆管造影术 (MRCP)
  • 超声内镜扫描(EUS)
  • 腹部 CT 扫描
完整详情

治疗流程

急症处理

有症状的胆石症

有或无症状的胆总管结石

持续性治疗

无症状的胆石症

撰稿人

专家顾问

Eldon Shaffer, MD, FRCPC

Emeritus Professor of Medicine

Division of Gastroenterology

University of Calgary

Calgary

Canada

利益声明

ES declares that he has no competing interests.

Acknowledgements

Professor Eldon Shaffer would like to gratefully acknowledge Dr Vikesh K. Singh and Dr Anthony N. Kalloo, previous contributors to this topic.

利益声明

VKS and ANK declare that they have no competing interests.

同行评议者

Christian Macutkiewicz, MD, FHEA, FRCS

Consultant General and Hepato-Pancreato-Biliary Surgeon

Clinical Lead for Emergency General Surgery, Gastrointestinal Medicine, and Surgery CSU

Manchester Royal Infirmary

Manchester

Director of Scientific Programme

Association of Surgeons of Great Britain and Ireland

UK

利益声明

CM declares that he has no competing interests.

Luke Evans, MBBS, FRCS (GenSurg) MCh, DGM, FEBS (Emerg Surg)

Consultant in Emergency General Surgery

Service Director for Emergency Assessment Unit (Surgical)

Norfolk and Norwich University Hospitals

Norwich

UK

利益声明

LE declares that he has no competing interests.

编辑

Celia Pincus

Section Editor, BMJ Best Practice

利益声明

CP declares that she has no competing interests.

Jo Haynes

Head of Editorial, BMJ Knowledge Centre

利益声明

JH declares that she has no competing interests.

Adam Mitchell

Drug Editor, BMJ Best Practice

利益声明

AM declares that he has no competing interests.

Julie Costello

Comorbidities Editor, BMJ Best Practice

利益声明

JC declares that she has no competing interests.

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