壶腹周围憩室对胆管结石和壶腹癌的影响。
Impact of Periampullary Diverticula on Bile Duct Stones and Ampullary Carcinoma.
作者信息
Örmeci Necati, Deda Xheni, Kalkan Çağdaş, Tüzün Ali Emrehan, Karakaya Fatih, Dökmeci Abdulkadir, Bahar D Kadir, Özkan Hasan, İdilman Ramazan, Çınar Kubilay
机构信息
Department of Gastroenterology, Ankara University School of Medicine, Ankara, Turkey.
出版信息
Euroasian J Hepatogastroenterol. 2016 Jan-Jun;6(1):31-34. doi: 10.5005/jp-journals-10018-1162. Epub 2016 Jul 9.
INTRODUCTION
Periampullary diverticula (PD) is caused by extraluminal pouching of duodenal mucosa. Using a very common endoscopic procedure to diagnose or treat gastrointestinal disorders, we encountered duodenal diverticulum.
MATERIALS AND METHODS
This is a retrospective, single-center study. Three thousand and sixteen patients on whom endoscopic retrograde cholangiopancreatography (ERCP) was performed at Ankara University Medical School, Department of Gastroenterology, from June 2009 to June 2014 were included to the study.
RESULTS
Hundred and thirty patients (males 65, females 65) among the 3,016 had PD. Two hundred and sixty patients without diverticulum were randomly chosen from the 3,016 patients, as a control group [121 (47%) females, 139 (53%) males]. There was no statistical difference between the two groups. The mean age of the patients with PD was 69.9 years, while the mean age was 62.3 years for patients without PD (p < 0.001). Incidence for PD was 4.6%. The papilla of Vater was located in the inter-diverticular area (Type 1) in 9 patients (8.3%), at the edge of the diverticulum (Type 2) in 31 patients (28.4%), and at a distance of 2 to 3 cm from the papilla (Type 3) in 69 patients (63.3%).
DISCUSSION
Although numerically more common bile duct stones occurred in patients with PD compared to those without PD, there was no statistical difference between the two groups. The rate of pancreato-biliary carcinomas was higher in patients without diverticulum. Cannulation was successful in both groups at the rate of 97.6 and 92% respectively, but cannulation failed more often in patients without PD. Duodenal perforation occurred in one patient with PD. Bleeding after sphincterotomy occurred in two patients without PD.
HOW TO CITE THIS ARTICLE
Örmeci N, Deda X, Kalkan Ç, Tüzün AE, Karakaya F, Dökmeci A, Bahar DK, Özkan H, İdilman R, Çınar K. Impact of Periampullary Diverticula on Bile Duct Stones and Ampullary Carcinoma. Euroasian J Hepato-Gastroenterol 2016;6(1):31-34.
引言
壶腹周围憩室（PD）是由十二指肠黏膜的腔外袋状突起引起的。在使用一种非常常见的内镜检查程序诊断或治疗胃肠道疾病时，我们遇到了十二指肠憩室。
材料与方法
这是一项回顾性单中心研究。纳入了2009年6月至2014年6月在安卡拉大学医学院胃肠病学系接受内镜逆行胰胆管造影（ERCP）的3016例患者。
结果
3016例患者中有130例（男性65例，女性65例）患有PD。从3016例患者中随机选取260例无憩室的患者作为对照组[女性121例（47%），男性139例（53%）]。两组之间无统计学差异。PD患者的平均年龄为69.9岁，无PD患者的平均年龄为62.3岁（p<0.001）。PD的发生率为4.6%。9例（8.3%）患者的 Vater 乳头位于憩室间区域（1型），31例（28.4%）患者的乳头位于憩室边缘（2型），69例（63.3%）患者的乳头距乳头2至3cm（3型）。
讨论
虽然与无PD的患者相比，PD患者中胆管结石在数量上更为常见，但两组之间无统计学差异。无憩室患者的胰胆管癌发生率较高。两组的插管成功率分别为97.6%和92%，但无PD患者的插管失败更为常见。1例PD患者发生十二指肠穿孔。2例无PD患者在括约肌切开术后出血。
如何引用本文
Örmeci N, Deda X, Kalkan Ç, Tüzün AE, Karakaya F, Dökmeci A, Bahar DK, Özkan H, İdilman R, Çınar K. 壶腹周围憩室对胆管结石和壶腹癌的影响。《欧亚肝脏胃肠病学杂志》2016；6(1):31 - 34。
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