Dufek V
I. interní klinika 1. LF UK, Praha.
Vnitr Lek. 1994 Jun;40(6):382-5.
Stenosis of the ampulla of Vater is encountered in as many as 10% of patients with biliary diseases. In general it is classified as tumourous, inflammatory of functional stenosis. In the clinical picture biliary dyspepsia associated with cholestasis predominates. The cause of functional stenosis of the ampulla of Vater is not known. In the development of inflammatory stenosis most frequently iatrogenic damage of the ampulla during revision of the biliary pathways participates or repeated passage of concrements in cholecystolithiasis. Treatment of tumours of the ampulla of Vater is surgical, treatment of inflammatory stenosis is endoscopic by endoscopic papillotomy. In the treatment of functional stenosis a useful drug is hymecromon, as a rule combined with metoclopramide.
在多达10%的胆道疾病患者中会出现 Vater 壶腹狭窄。一般来说，它被分为肿瘤性、炎症性或功能性狭窄。在临床表现中，以胆汁淤积相关的胆源性消化不良为主。Vater 壶腹功能性狭窄的病因尚不清楚。在炎症性狭窄的发生过程中，胆道通路修复时壶腹最常受到医源性损伤，或胆囊结石症中结石反复通过。Vater 壶腹肿瘤的治疗是手术治疗，炎症性狭窄的治疗是通过内镜乳头切开术进行内镜治疗。在功能性狭窄的治疗中，有效的药物是曲匹布通，通常与甲氧氯普胺联合使用。
