不同乳头切开法在合并十二指肠乳头旁憩室的特发性胰腺炎中的应用价值  

Diagnostic value of different endoscopic sphincterotomy procedures in idiopathic pancreatitis combined with juxtapapillary duodenal diverticulum

作　　者：陈莉丽 卜平 陈超伍 邓登豪 刘军 陈娟 

机构地区：[1]扬州大学临床医学院附属医院消化内科苏北人民医院消化内科,江苏省扬州市225001

出　　处：《世界华人消化杂志》2014年第25期3853-3856,共4页World Chinese Journal of Digestology

摘　　要：目的:评价不同的乳头切开法在合并十二指肠乳头旁憩室(juxtapapillary duodenal diverticulum,JPD)的特发性胰腺炎(idiopathic pancreatitis,IP)中的诊治价值.方法:回顾性研究扬州大学临床医学院附属医院7年来收治的18例合并JPD的IP,通过比较二种不同的乳头括约肌切开(endoscopicsphincterotomy,EST)方式,比较其术后的并发症,并随访复发率.结果:18例患者成功17例,成功率94.44%,EST17例,其中小切开+柱状气囊扩张8例,中切开9例,鼻胆管引流14例,胆管支架置入3例,中切开组术中少量出血2例,术后出血1例,两组皆无严重的穿孔、死亡等并发症.结论:十二指肠乳头小切开+柱状气囊扩张对于合并JPD的IP,可能更为安全有效,能够进一步明确病因、有效的控制并预防复发,值得临床推广,但仍需进一步扩张样本量进一步研究.AIM： To evaluate the diagnostic value of different endoscopic sphincterotomy procedures in patients with idiopathic pancreatitis combined with juxtapapillary duodenal diverticulum.METHODS： A retrospective study of 18 patients who were diagnosed with idiopathic pancreatitis combined with juxtapapillary duodenal diverticula and treated at our hospital over the past seven years was performed.The postoperative complications and recurrence rate were compared between patients undergoing two different sphincterotomy procedures.RESULTS： Of the 18 patients, 17 underwent endoscopic retrograde cholangiopancreatography（ERCP）, and the success rate was 94.44%. All these 17 patients received endoscopic sphincterotomy, of whom 8 received small incision and balloon dilatation and 9 received middle incision; 14 received endoscopic nasal bile duct drainage and 3 received bile duct stenting. In the middle incision group, 2 cases had intraoperative minor bleeding and 1 case developed postoperative gastrointestinal bleeding. No major complications such as massive perforation were observed in the two groups.CONCLUSION： The small incision and balloon dilatation method may be more safe and effective in patients with idiopathic pancreatitis combined with juxtapapillary duodenal diverticulum, and it can also help clarify the etiology and achieve effective control and prevention of recurrence.

关 键 词：特发性胰腺炎 不同的乳头肌切开术 十二指肠憩室旁乳头 逆行胰胆管造影术 

分 类 号：R576[医药卫生—消化系统]