Kennedy R H, Thompson M H
Department of Surgery, Southmead Hospital, Bristol.
Gut. 1988 Jul;29(7):1003-6. doi: 10.1136/gut.29.7.1003.
The results of 250 consecutive ERCP examinations were analysed in order to assess whether or not juxtapapillary duodenal diverticula are associated with choledocholithiasis. Cholangiography showed common bile duct stones in 71 patients of whom 25 (35%) had periampullary diverticula. Clear bile ducts were shown in 99, of whom only 12 had diverticula (12%) (p less than 0.05). After allowing for the differences in age between the two groups, patients with choledocholithiasis were 2.6 times (95% CI: 1.14-5.93) more likely to have a periampullary diverticulum than patients without choledocholithiasis. In the remaining 80 patients, cholangiography was either not successful or not indicated. Further clinical follow up and/or investigation have failed to reveal duct stones in any and only 10 (13%) of these 80 patients had diverticula. Overall, 47 patients had diverticula: 25 (53%) had duct stones, four may have had stones and 18 had none. Three or more years after cholecystectomy 59% of patients with duct stones had diverticula, while only 13% with clear ducts had them. These results show a significant association between periampullary duodenal diverticula and choledocholithiasis.
分析了连续250例内镜逆行胰胆管造影（ERCP）检查的结果，以评估十二指肠乳头旁憩室是否与胆总管结石相关。胆管造影显示71例患者有胆总管结石，其中25例（35%）有壶腹周围憩室。99例显示胆管清晰，其中只有12例有憩室（12%）（P<0.05）。在考虑两组年龄差异后，胆总管结石患者有壶腹周围憩室的可能性是无胆总管结石患者的2.6倍（95%可信区间：1.14-5.93）。在其余80例患者中，胆管造影要么未成功，要么未进行。进一步的临床随访和/或检查未能在任何患者中发现胆管结石，这80例患者中只有10例（13%）有憩室。总体而言，47例患者有憩室：25例（53%）有胆管结石，4例可能有结石，18例无结石。胆囊切除术后三到多年，59%有胆管结石的患者有憩室，而胆管清晰的患者只有13%有憩室。这些结果表明壶腹周围十二指肠憩室与胆总管结石之间存在显著关联。
