Straja D, Marincaş M, Alecu M, Boroghina G, Simion L, Stanescu A, Drilea E, Brătucu E
Oncological and General Surgery Clinic I, Institute of Oncology Bucharest.
Chirurgia (Bucur). 2009 Nov-Dec;104(6):687-96.
The aim of this paper is to identify the early and late implications of JPDD for biliary pathology, as well as for endoscopic therapy and classical surgery dealing mainly with lithiasis. This paper is based on a retrospective study comprising a number of 675 ERCP performed on 601 patients between 1997-2007, out of which 399 cases were followed by therapeutic measures. A total of 79 procedures were performed on 65 cases with JPDD. The main criteria were: gender, age, indications regarding the performance of ERCP+/-ES, complications that occurred while carrying out these procedures. In all the cases examined (601) the percentage of JPDD reported was of 10.81%. The rate of complications in the sphincterotomized patients without JPDD was 5.75% and the rate in the sphincterotomized patients with JPDD was 14.89%. In conclusion, the paper discusses the clinical and therapeutic implications of JPDD in biliary pathology. It has been found that JPDD is an important etiological cause for the late diseases occurring after cholelithiasis surgery. JPDD also leads to immediate therapeutic implications such as: difficult cannulation and high incidence of ERCP+/-ES complications.
本文旨在明确十二指肠乳头憩室（JPDD）对胆道病理以及主要针对结石病的内镜治疗和传统手术的早期及晚期影响。本文基于一项回顾性研究，该研究纳入了1997年至2007年间对601例患者实施的675例内镜逆行胰胆管造影（ERCP），其中399例随后采取了治疗措施。对65例患有JPDD的患者共实施了79项操作。主要标准包括：性别、年龄、关于ERCP±内镜括约肌切开术（ES）操作的适应证、实施这些操作时发生的并发症。在所有检查的病例（601例）中，报告的JPDD发生率为10.81%。未患JPDD的括约肌切开术患者的并发症发生率为5.75%，而患JPDD的括约肌切开术患者的并发症发生率为14.89%。总之，本文讨论了JPDD在胆道病理中的临床及治疗意义。研究发现，JPDD是胆结石手术后晚期疾病的一个重要病因。JPDD还导致直接的治疗影响，如插管困难以及ERCP±ES并发症的高发生率。
