総胆管結石症の診断の進歩

Diagnostic Progress of Choledocholithiasis

　最近の，国の内外を問わない消化器病学領域にみられる出版物のブーム状態はどう評価したらよいのだろう．本当に，心の底から喜んでよいのか，われわれ“渦中の人”はいささかとまどうのである．単行本だけではない．消化器の専門誌もいくつか登場した．それぞれの雑誌は，優れた個性を備えているので，まさか過当競争にはならないだろうと想像しているが，今後激しい鍔迫り合いが続くだろうと思っている．

　蛇足ではあるが，わが「胃と腸」は，単に消化管だけを守備範囲として編集されているものではない．このことは，少し息の長い読者ならよく御存じのはずである．膵も，胆道系も，「胃と腸」の重要なterritoryとみなしている．消化管の病態生理，病変を十分に考慮しないで，膵とか胆道系の病態が正しく理解できるわけはないし，逆もまた真である．

　Diagnostic approach to stones in the choledochus has made such a tremendous progress, because in addition to excretory choledochography (intravenous and DIC), ERCP, PTC, new diagnostic methods such as US and CT have come into wide use in recent years. In this paper is described an outline of these new diagnostic methods and summing up of their progress. Problems sure to arise in future in this field are also referred to.

　When one wants to obtain minute information about stones in the common bile duct, it is surprising that most of the literature about them are included in that of cholelithiasis. Systematic reports of stones in the choledochus alone are few contrary to one's expectations. I hope that the special issue of the “Stomach and Intestine”would become a trigger for the readers to pay closer attention to diseases of the bile duct.