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乳头切开术还是乳头成形术?乳头手术后的临床及内镜随访

[Papillotomy or papilloplasty? Clinical and endoscopic follow-up after papillary surgery].

作者信息

Tondelli P, Gyr K, Lüscher N, Schuppisser J P, Stalder G A, Allgöwer M

出版信息

Helv Chir Acta. 1979 Feb;45(6):687-92.

PMID:429164
Abstract

We controlled patients after surgical incision of the papilla for papillary stone or papillary stenosis. 131 were examined clinically, 39 of them additionally with ERCP. The endoscopy showed that simple cutting of the papilla (i.e. papillotomy) often resulted in a restenosis because of accretion of the incised duodenal mucosa. This was prevented by the additional suture of the choledochal and duodenal mucosa (i.e. papilloplasty). The clinical results, however, were equally good with both surgical techniques. This rises the question in view of the striking endoscopical results, whether the clinical examination alone is an adequate criterion to detect stasis disorders of the liver and the pancreas. The results confirm us to perform, when surgical incision of the papilla is necessary, rather a papilloplasty than a papillotomy.

摘要

我们对因乳头结石或乳头狭窄而进行乳头手术切开的患者进行了对照研究。131例患者接受了临床检查,其中39例还接受了内镜逆行胰胆管造影(ERCP)检查。内镜检查显示,单纯的乳头切开术(即乳头括约肌切开术)常常因切开的十二指肠黏膜增生而导致再狭窄。通过胆总管和十二指肠黏膜的附加缝合(即乳头成形术)可预防这种情况。然而,两种手术技术的临床效果同样良好。鉴于显著的内镜检查结果,这就提出了一个问题,即仅靠临床检查是否足以作为检测肝脏和胰腺淤滞性疾病的标准。结果证实,在有必要进行乳头手术切开时,我们应更倾向于进行乳头成形术而非乳头括约肌切开术。

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