中国全科医学2016，Vol.19Issue(9)：1028-1031,4.DOI:10.3969/j.issn.1007-9572.2016.09.009
十二指肠乳头旁憩室与胆总管结石的关系及其对经内镜逆行胰胆管造影术取石效果的影响
Relation Between Periampullary Diverticula and Choledocholithiasis and the Effect of Periampullary Diverticula on ;Removing Calculus by Endoscopic Retrograde Cholangiopancreatography
范燕云 1林梦婕 2林振和 1刘文明1
作者信息
- 1. 361004 福建省厦门市，厦门大学附属中山医院消化内科
- 2. 361004 福建省厦门市，厦门大学附属中山医院病理科
- 折叠
摘要
Abstract
Objective To explore the relation between periampullary diverticula ( PAD) and choledocholithiasis and the effect of PAD on removing calculus by endoscopic retrograde cholangiopancreatography ( ERCP ) .Methods The clinical data of 351 patients who received ERCP in Zhongshan Hospital Xiamen University from July 2011 to July 2013 were analyzed retrospectively.The patients were divided into PAD group ( n =67 ) and non PAD group ( n =284 ) according to whether the patients suffered from PAD.The occurrence rate of choledocholithiasis was analyzed and compared between PAD group and non PAD group and among patients with different relative locations ( circumvolution type, parallel type, marginal type) between PAD and duodenal papilla; the effect of removing calculus ( success rate of removing calculus and postoperative complications ) by ERCP was analyzed and compared between PAD patients accompanied by choledocholithiasis and non PAD patients accompanied by choledocholithiasis.Results The difference was significant in sex, age and the occurrence rate of choledocholithiasis between the two groups ( P <0.05 ) .The occurrence rates of malignant tumor, Oddi sphincter dysfunction, chronic pancreatitis, hypertension, diabetes and cardiopathy were not significantly different between the two groups ( P>0.05) .The occurrence rate of PAD increased with age (P<0.05) .The occurrence rate of choledocholithiasis of marginal type PAD patients was higher than that of circumvolution type PAD patients and parallel type PAD patients ( P <0.05 ) .The difference in the success rate of removing calculus, the occurrence rate of acute pancreatitis after operation and the occurrence rate of bleeding during operation were not significantly different between PAD patients accompanied by choledocholithiasis and non PAD patients accompanied by choledocholithiasis (P>0.05) .Conclusion PAD might be one of the reasons of choledocholithiasis, and the effect of PAD on removing calculus by ERCP is limited.As long as the skills of endoscopy are grasped and the manner of operation is paid attention, removing calculus by ERCP is still a safe and effective treatment method for PAD patients accompanied by choledocholithiasis.关键词
憩室/十二指肠/胆总管结石/胰胆管造影术, 内窥镜逆行Key words
Diverticulum/Duodenum/Choledocholithiasis/Cholangiopancreatography, endoscopic retrograde分类
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范燕云,林梦婕,林振和,刘文明..十二指肠乳头旁憩室与胆总管结石的关系及其对经内镜逆行胰胆管造影术取石效果的影响[J].中国全科医学,2016,19(9):1028-1031,4.
