Benoit G, Larrieu H
Sem Hop. 1980;56(17-18):847-52.
The authors have studied 36 cases of duodenal diverticula detected during 500 biliary operations. Initial pre-operative diagnosis was based on upper gastrointestinal barium series alone. Fiberopticduodenoscopy was unable to detect the diverticula. Patients were studied by cholangiocinesimetry. This technic demonstrated that oddian activity was satisfactory, with normal sphincter pressures and thus eliminated any suspicion of odditis. In this series, diverticula of the duodenal window lead to no more complications than do cholelithiasis, acute cholecystis or acute pancreatitis. The repercussion of the diverticula seems then to be limited to isolated dilatation of the common bile duct. In treating, the authors conclude that, in case of common bile duct dilatation, external drainage or biliodigestive anastomosis is recommended. Sphincterotomy is not indicated. All direct surgery on the diverticula, responsible for heavy morbidity and mortality rates, is to be avoided.
作者研究了在500例胆道手术中发现的36例十二指肠憩室。最初的术前诊断仅基于上消化道钡剂造影。纤维十二指肠镜检查未能发现憩室。对患者进行了胆管测压。这项技术表明奥狄氏括约肌活动良好,括约肌压力正常,因此排除了任何奥狄氏括约肌炎的怀疑。在这个系列中,十二指肠窗憩室导致的并发症并不比胆石症、急性胆囊炎或急性胰腺炎多。憩室的影响似乎仅限于胆总管的孤立扩张。在治疗方面,作者得出结论,在胆总管扩张的情况下,建议进行外引流或胆肠吻合术。不建议进行括约肌切开术。应避免对憩室进行所有直接手术,因为这会导致高发病率和死亡率。