十二指肠乳头旁憩室与胆管结石复发的关系-论文.pdf

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1、中华普通外科杂志2014年7月第29卷第7期ChinJGenSurg，July2014．Vo1．29，No．7·495·．胆管疾病十二指肠乳头旁憩室与胆管结石复发的关系柏文辉程利江平罗广孙权【摘要】目的探讨十二指肠乳头旁憩室与胆管结石复发的关系。方法回顾性分析2008年8月至2012年12月中南医院行内镜逆行胰胆管造影术的829例患者的完整临床资料，将其分为胆总管结石组(609例)、胆总管异常组(124例)、胆总管未见异常伴肝内胆管结石或胆囊结石组(38例)及对照组(58例)，其中十二指肠憩室者206例，无憩室者623例，分析十二指肠乳头旁憩室与胆管结石的形成与复发、术后胰

2、腺炎及插管失败的关系。结果胆总管结石组憩室发生率(27．8％)比胆总管异常组(18．5％)高()(=4．512，P<0．05)。憩室者术后胰腺炎发病率(33．7％)较无憩室者(13．8％)高(×=30．841，P<0．05)。胆总管结石组伴有憩室者插管失败率(15．4％)高于无憩室者(6．8％)(X：0．731，P<0．05)。胆总管结石组术后复发率在伴有憩室者(19．5％)明显高于无憩室者(9．3％)(X2=14．51，P<0．05)。结论十二指肠憩室与结石形成、ERCP术后胰腺炎、插管失败、结石复发均有关。【关键词】憩室；肝胰管壶腹；胆结石；复发Therelations

3、hipbetweenjuxtapapillaryduodenaldiverticulumandrecurrenceofbiliarystonesBaiWenhui，ChengLi，JiangP，LuoGuang，SunQuan．DepartmentofGeneralSurgery，ZhongnanHospitalofWuhanUniversity，Wuhan430071，ChinaCorrespondingauthor：SunQuan．E—mail：529454653@qq．COB【Abstract】0bjectiveToexplorewhetherthepresenceo

4、fjuxtapapillaryduodenaldiverticula(JPDD)risksbiliarystonediseaseandrecurence．Methods829patientsundergoingERCPinourhospitalfromAug2008toDec2012weredividedintofourgroups：biliarystonedisease(n=609)non．stonebiliarvabnormality(n=124)commonbileductmalformationwithcholelithiasis(n=38)andnormalcon

5、trolgroup(n=58)．Therewere206patientswithJPDDand623patientswithoutJPDD．Biliarystoneformation，post·ERCPpancreatitis，cannulationfailure，andstonerecurrencewerecomparedbetweenthosewithJPDDandthosewithout．ResultsTheincidenceofJPDDinbiliarystonediseasegroup(27．8％)wassignificantlyhigherthaninnon—s

6、tonebiliaryanatomicalabnormalitygroup(18．5％)(X：4．512，P<0．05)．Inbiliarystonediseasegroup，ratesofpost-ERCPpancreatitisweresignificantlyhigherinJPDDcases(33．7％)comparedtothosewithoutJPDD(13．8％)(×=30．841，P<0．05)．rhecannulationfailureratewasalsohigherinpatientswithJPDD(15．4％)comparedtoJPDDnegat

7、ive(6．8％)(X=0．731．P<0．05)．RecurrenceratesinbiliarystonediseaseweresignificantlyhigherinpatientswithJPDD(19．5％)whencomparedtoJPDD—lackingindividuals(9．3％)(X：14．51，P<0．05)．ConclusionsJPDDisariskfactorforbiliarystoneformation．JPDDalsoisassociatedwithpost—ERCPpanc