十二指肠乳头憩室275例的诊断与治疗  

Diagnosis and treatment of 275 cases of juxta-ampullary duodenal diverticulum

作　　者：聂自宏 王运兵[1] 欧志兵[1] 龚建平[1] 

机构地区：[1]重庆医科大学附属第二医院肝胆外科,重庆400010 [2]重庆市奉节县医院外一科,重庆奉节404600

出　　处：《现代医药卫生》2014年第8期1124-1126,共3页Journal of Modern Medicine & Health

摘　　要：目的分析275例十二指肠乳头憩室病例,总结诊治经验。方法选取1981年1月到2011年1月行经内镜逆行性胰胆管造影(ERCP)检查诊断为十二指肠乳头憩室(JAD)并接受了治疗的患者275例。根据憩室与十二指肠乳头的位置,将所有JAD患者进行分类,并对其中114例(41.5%)患者进行了手术治疗。结果 275例JAD患者被分为A型和B型,分别为174例(63.3%)和101例(36.7%)。在A型患者中44例(25.3%)因出现憩室炎、出血、穿孔及胆道结石等并发症而最终接受手术治疗;B型患者中70例(69.3%)因出现上述严重并发症而接受手术治疗。结论 ERCP是JAD的主要诊断方式。JAD可以根据憩室与十二指肠乳头的位置关系分为两种类型;有严重并发症的患者需要进行手术治疗。Objective To analyze 275 patients with juxta-ampullary duodenal diverticulum （JAD） and summarize the experience of diagnosis and treatment. Methods A total of 275 patients, who were diagnosed as JAD by endoscopic retrograde cholangiopancreatography （ERCP） in the hospital from January 1981 to January 2011, were selected. All the diagnosed patients were classified based on the location of diverticulum and duodenal papilla, and 114 eases （41.5%） were treated with surgery. Results The 275 patients with JAD were divided into type A （n=174,63.3%） and type B （n=101,36.7% ）. In 44 patients （25.3%） of type A, complications like diverticulitis, bleeding, perforation and bile calculus were occurred and operated finaUy ;in 70 patients （69.3%） of type B, the above serious complications were occurred and operated. Conclusion ERCP is a major approach to diagnose JAD. JAD can be divided into two types according to the positional relation of diverticulum and duodenal papilla, and the patients with serious complications require surgical intervention.

关 键 词：憩室 十二指肠疾病 胰胆管造影术 内窥镜逆行 诊断 鉴别 

分 类 号：R575.7[医药卫生—消化系统]