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经十二指肠乳头成形术后的临床及内镜放射学结果(作者译)

[Clinical and endoscopic radiologic results after transduodenal papilloplasty (author's transl)].

作者信息

Belohlavek D, Merkle N, Heil T, Voss U, Herfarth C

出版信息

Med Klin. 1979 Apr 27;74(17):655-61.

PMID:440190
Abstract

The study comprises 56 patients, who underwent transduodenal papilloplasty. More than 15% were symptom-free at least 4 years following surgery. All the symptoms the patients suffered from were nonspecific and the pathological findings of the blood samples were not correlated with the width of the orificium of the papilla of Vater or the diameter of the common bile duct. In 49 patients the ERCP was performed. In 48 cases the retrograde cholangiography was successful, in 1 case only the retrograde pancreatography was possible. In all patients we found normal efflux of contrastmedium out of the papilla. Bile stones, one localized in the common bile duct and the other in the cyst remnant were the most important findings. The diameters of the common bile ducts varied considerably and were not dependent on the velocity of the efflux of the contrast medium. Contrary to the observations of other authors, in only 15% of our patients free air bubbles were found in the bile tree. Peripapillary diverticula of the duodenum were detected in 15% of our patients, but did not lead to compression or obstruction of the common bile duct. Even without histologic examination of the liver, we believe that a broad papilloplasty of the papilla prevents an ascending cholangitis or other related complications.

摘要

该研究包括56例接受经十二指肠乳头成形术的患者。超过15%的患者在术后至少4年无症状。患者所患的所有症状均不具有特异性,血液样本的病理检查结果与 Vater 乳头开口宽度或胆总管直径无关。49例患者进行了内镜逆行胰胆管造影(ERCP)。48例逆行胆管造影成功,1例仅可行逆行胰管造影。在所有患者中,我们发现造影剂从乳头正常流出。最重要的发现是胆管结石,1枚位于胆总管,另1枚位于胆囊残端。胆总管直径差异很大,与造影剂流出速度无关。与其他作者的观察结果相反,我们的患者中只有15%在胆管树中发现游离气泡。15%的患者检测到十二指肠乳头周围憩室,但未导致胆总管受压或梗阻。即使没有对肝脏进行组织学检查,我们也认为对乳头进行广泛的乳头成形术可预防上行性胆管炎或其他相关并发症。

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