Guma C L, Luis A
Sección de Hepatología y via biliar, Centros Médicos SMATA, Provincia de Buenos Aires, Argentina.
Medicina (B Aires). 1990;50(2):124-8.
The Sump syndrome is an infrequent complication of a choledochoenterostomy (choledochoduodenostomy or choledochojejunostomy) performed for recurrent stone disease: a sump or pit develops at the retroduodenal section of the choledochus between the enterostomy and papilla where stones, lithogenic bile and gastrointestinal contents accumulate. This may lead to abdominal pain, pancreatitis and cholestasis and/or cholangitis when sludge obstructs the enterostomy. Surgical treatment has been replaced by endoscopic papillotomy. The major interest of this experience was that regarding migration of the stones to intestine, the spontaneous resolution could be documented in two patients; in other two cases, because of contraindications in one case and for refusing therapy in another, the stones still remain at the retroduodenal choledochus. In a follow up of two to eight years there is a favorable evolution without any surgical or endoscopic treatment of the papilla.
贮留综合征是因复发性结石病而行胆总管肠吻合术(胆总管十二指肠吻合术或胆总管空肠吻合术)后一种罕见的并发症:在胆总管十二指肠后段,肠吻合口与乳头之间形成一个贮留腔或陷凹,结石、致石性胆汁及胃肠道内容物在此积聚。当胆泥阻塞肠吻合口时,可导致腹痛、胰腺炎及胆汁淤积和/或胆管炎。手术治疗已被内镜下乳头切开术所取代。该病例的主要意义在于,对于结石向肠道的迁移,有两名患者结石可自行溶解;另外两例中,一例因存在禁忌证,另一例因拒绝治疗,结石仍留在十二指肠后段胆总管内。在2至8年的随访中,未对乳头进行任何手术或内镜治疗,但病情仍向好的方向发展。