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[自身材料中的十二指肠憩室与胆总管结石]

[Duodenal diverticula and choledocholithiasis in own material].

作者信息

Zajac Aleksander, Solecki Rafał, Kruszyna Tomasz, Krzeszowiak Jolanta

机构信息

I Katedra Chirurgii Ogólnej, Uniwersytetu Jagiellońskiego w Krakowie, Klinika Chirurgii Gastroenterologicznej.

出版信息

Przegl Lek. 2005;62(12):1398-400.

Abstract

The detectability of duodenal diverticula (DD), a common duodenal pathology, has been growing with the increasing availability of endoscopic examinations, and especially of endoscopic retrograde cholangio-pancreatography (ERCP). The study is a retrospective analysis of incidence rates of DD and accompanying diseases of bile ducts, liver and pancreas detected by ERCP. We performed 8642 ERCP examinations between 1974 and 2001, which detected DD in 622 (7.2%) patients. Of these, 409 (65.8%) had choledocholithiasis, and 97 (15.6%) liver, gallbladder, bile ducts or pancreatic cancer. In the remaining 106 (17.0%) patients no pathologies requiring surgical intervention were found by radiological examination of bile ducts and pancreatic duct. In 10 (1.6%) patients with DD, caniulation of Vater papilla was not performed due to its anatomical location. Obtained results confirm relationship between DD and choledocholithiasis. It has not been established whether DD predispose to choledocholithiasis by interfering with bile duct emptying and causing bile lithogenicity, or rather that duodenal diverticula are caused by a concrement moved to duodenum by contractions of the gallbladder or sphincter of Oddi.

摘要

十二指肠憩室(DD)作为一种常见的十二指肠病变,随着内镜检查尤其是内镜逆行胰胆管造影(ERCP)的普及,其检出率不断提高。本研究对通过ERCP检测出的DD以及胆管、肝脏和胰腺相关疾病的发病率进行了回顾性分析。1974年至2001年间,我们共进行了8642例ERCP检查,其中622例(7.2%)患者被检测出患有DD。在这些患者中,409例(65.8%)患有胆总管结石,97例(15.6%)患有肝脏、胆囊、胆管或胰腺癌。在其余106例(17.0%)患者中,通过胆管和胰管的影像学检查未发现需要手术干预的病变。在10例(1.6%)患有DD的患者中,由于Vater乳头的解剖位置,未进行插管操作。所得结果证实了DD与胆总管结石之间的关系。目前尚未确定DD是通过干扰胆管排空并导致胆汁成石性而诱发胆总管结石,还是十二指肠憩室是由胆囊或Oddi括约肌收缩将结石移至十二指肠所致。

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