目的 探討十二指腸憩室尤其是乳頭旁憩室在并發(fā)膽道疾病時(shí)的臨床診治問(wèn)題。
方法 對(duì)我院近5年收治的18例十二指腸憩室進(jìn)行分析。總結(jié)了憩室合并膽管結(jié)石的臨床問(wèn)題，尤其是膽囊膽管術(shù)后癥狀不消失，再發(fā)現(xiàn)十二指腸乳頭旁憩室，回顧了外科手術(shù)問(wèn)題。
結(jié)果 十二指腸憩室18例，17例位于乳頭旁。2/3以上病例年齡大于50歲。16例(8889%)并發(fā)膽管結(jié)石，7例(3889%)曾行膽囊切除或膽總管切開(kāi)取石、T管引流術(shù)，術(shù)后仍有癥狀，經(jīng)十二指腸低張?jiān)煊昂停駿RCP檢查發(fā)現(xiàn)十二指腸乳頭旁憩室。16例行不同手術(shù)治療，效果良好。無(wú)并發(fā)癥，無(wú)死亡病例。
結(jié)論 十二指腸乳頭旁憩室與膽管結(jié)石關(guān)系密切； 十二指腸低張?jiān)煊昂虴RCP檢查是確診本病可靠的方法； 當(dāng)膽道術(shù)后仍有癥狀或反復(fù)發(fā)生膽總管色素性結(jié)石時(shí)，應(yīng)行內(nèi)鏡或十二指腸低張?jiān)煊皺z查，以除外十二指腸乳頭旁憩室之可能； 當(dāng)憩室有合并癥發(fā)生時(shí)應(yīng)考慮手術(shù)治療。
引用本文： 程南生,熊先澤,彭其芳. 十二指腸乳頭旁憩室與膽道疾病(附18例報(bào)告). 中國(guó)普外基礎(chǔ)與臨床雜志, 2001, 8(3): 173-175. doi: 復(fù)制
| 1. | 盧木發(fā)，鄭國(guó)勤，熊浩.十二指腸憩室內(nèi)潰瘍的診斷 〔J〕. 中外醫(yī)用放射技術(shù)，1998； 2(2)∶88. |
| 2. | Lobo DN, Balfour TW, Iftikhar SY, et al. Periampullary diverticula and pancreaticobiliary disease 〔J〕. Br J Surg, 1999； 86(5)∶588. |
| 3. | Vomo G, Manes G, Ragozzino A, et al. Periampullary extraluminal duodenal diverticula and acute pancreatitis:an underestimated etiological association 〔J〕. Am J Gastroenterol, 1996； 91(6)∶1186. |
| 4. | Nagakawa J, Kanno M. Ueno K, et al. Intrabiliary pressure measurement by duodenal pressure loading for the evaluation of duodenal parapapillary diverticulum 〔J〕. Hepatogastroenterology, 1996； 43(1)∶1129. |
| 5. | Kennedy RH, Thompson MH. Are duodenal diverticula associated with choledocholithiasis 〔J〕？ Gut, 1988； 29(7)∶1003. |
| 6. | Kimura W, Nagai H. No significant correlation between histologic changes of the papilla of vater and Juxtapapillary diverticulum. Special reference to the pathogenesis of gallstones 〔J〕. Scand J Gastroenterol, 1992； 27(11)∶951. |
| 7. | Lotveit T, Skar V, Osnes M. Juxtapapillary duodenal diverticula 〔J〕. Endoscopy, 1988； 20(Suppl 1)∶175. |
| 8. | Fellbaum Juxtapapillary duodenal diverticulumpathologic findings 〔J〕. Wien Klin Wochenschr, 1987； 99(14)∶502. |
| 9. | Iasu JP, Rocher L, Amouyal P, et al. Intraluminal duodenal diverticulum:radiological and endoscopoic ultrasonography findings of an unusual cause of acute pancreatitis 〔J〕. Eur Radiol, 1999； 9(9)∶1898. |
| 10. | 石景森，李發(fā)智，王林等.十二指腸憩室的外科治療 〔J〕.臨床外科雜志，1995； 3(5)∶241. |
| 11. | Kaminsky HH. Thompson WR, Davis B. Extended sphincteroplasty for juxtapapillary duodenal diverticulum 〔J〕. Surg Gynecol Obster, 1986； 162(3)∶280. |
- 1. 盧木發(fā)，鄭國(guó)勤，熊浩.十二指腸憩室內(nèi)潰瘍的診斷 〔J〕. 中外醫(yī)用放射技術(shù)，1998； 2(2)∶88.
- 2. Lobo DN, Balfour TW, Iftikhar SY, et al. Periampullary diverticula and pancreaticobiliary disease 〔J〕. Br J Surg, 1999； 86(5)∶588.
- 3. Vomo G, Manes G, Ragozzino A, et al. Periampullary extraluminal duodenal diverticula and acute pancreatitis:an underestimated etiological association 〔J〕. Am J Gastroenterol, 1996； 91(6)∶1186.
- 4. Nagakawa J, Kanno M. Ueno K, et al. Intrabiliary pressure measurement by duodenal pressure loading for the evaluation of duodenal parapapillary diverticulum 〔J〕. Hepatogastroenterology, 1996； 43(1)∶1129.
- 5. Kennedy RH, Thompson MH. Are duodenal diverticula associated with choledocholithiasis 〔J〕？ Gut, 1988； 29(7)∶1003.
- 6. Kimura W, Nagai H. No significant correlation between histologic changes of the papilla of vater and Juxtapapillary diverticulum. Special reference to the pathogenesis of gallstones 〔J〕. Scand J Gastroenterol, 1992； 27(11)∶951.
- 7. Lotveit T, Skar V, Osnes M. Juxtapapillary duodenal diverticula 〔J〕. Endoscopy, 1988； 20(Suppl 1)∶175.
- 8. Fellbaum Juxtapapillary duodenal diverticulumpathologic findings 〔J〕. Wien Klin Wochenschr, 1987； 99(14)∶502.
- 9. Iasu JP, Rocher L, Amouyal P, et al. Intraluminal duodenal diverticulum:radiological and endoscopoic ultrasonography findings of an unusual cause of acute pancreatitis 〔J〕. Eur Radiol, 1999； 9(9)∶1898.
- 10. 石景森，李發(fā)智，王林等.十二指腸憩室的外科治療 〔J〕.臨床外科雜志，1995； 3(5)∶241.
- 11. Kaminsky HH. Thompson WR, Davis B. Extended sphincteroplasty for juxtapapillary duodenal diverticulum 〔J〕. Surg Gynecol Obster, 1986； 162(3)∶280.