十二指肠乳头旁憩室与胆总管结石及胆囊切除术后综合征的关系  

The correlativity of Juxtapapillary diverticulum,choledocholithiasis and Postcholecystestomy Syndrome

作　　者：朱建清[1] 蒋丹斌[1] 乐红琴[1] 王福生[1] 蔡霞[1] 沈秀萍[1] 

机构地区：[1]江苏盐城市第三人民医院消化科,江苏盐城224001

出　　处：《胃肠病学和肝病学杂志》2008年第7期576-578,共3页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的探讨十二指肠乳头旁憩室(JPD)与胆总管结石及胆囊切除术后综合征(PCS)的关系。方法回顾分析313例患者经内镜逆行胰胆管造影(ERCP)资料,计算JPD的检出率;比较两组(憩室组和非憩室组)胆总管结石的发生率及60岁以上患者占有比例;分析114例胆囊切除术后患者ERCP造影结果。结果全组JPD检出率26.5%;憩室组胆总管结石的发生率显著高于非憩室组(82.9%vs56.1%,P<0.01),憩室组60岁以上者比例高于非憩室组(61.4%vs43.9%,P<0.05);114例胆囊切除术后患者ERCP造影显示胆总管结石的发生率80.4%,JPD合并发生率31.5%。结论随着年龄的增长,十二指肠乳头旁憩室的发生率增加,十二指肠乳头旁憩室是胆总管结石形成的重要危险因素,胆总管结石和十二指肠乳头旁憩室是胆囊切除术后综合征的两大主要原因。Objective To investigate the relatives of Juxtapapillary diverticulum（JPD） ,eholedoeholithiasis and Post- eholeeystestomy Syndrome（PCS）. Methods Three hundred and thirteen consecutive patients undergoing endoscopic retrograde eholangiopanereatography （ERCP） were prospectively enrolled. The detection rate of JPD was calculated. The patients were divided into two groups according to periampullary diverticula formation. The frequencies of bile duct gallstones and the proportion of patients over 60 were compared between two groups. Analysis on the ERCP figures of 114 patients received posteholeeystestomy. Results JPD positive patients accounted for 26.5% ; Incidence of the eho- ledoeholithiasis in patients who also had divertieulums was much higher than that of patients who had no divertieulums; The proportion of patients over 60 in the diverticulum group was more than that of non-diverticulum group; In 114 pa- tients who received posteholeeystestomy, 80.4% of them showed eholedoeholith during ERCP and 31.5% showed JPDs. Conclusion The incidence of JPD goes up with age, and JPD is one of the risk factors of eholedoeholithiasis. Choledoeholithiasis and JPD are the two major reasons of PCS.

关 键 词：十二指肠乳头旁憩室(JPD) 胆总管结石 胆囊切除术后综合征(PCS) 内镜逆行胰胆管造影(ERCP) 

分 类 号：R574.51[医药卫生—消化系统]