壶腹周围憩室的诊断和治疗

Diagnosis and treatment of periampullary diverticulum

目的寻求更理想的治疗壶腹周围憩室的手术方法，提出合理的病名和分型，介绍有关诊断的经验。方法复习因憩室引发的复发性胆管炎或（和）胰腺炎１１例，其中壶腹旁憩室９例，壶腹内憩室和壶腹膨大各１例。所有病例均行择期手术治疗，其中憩室－括约肌联合成形术７例，憩室切除加括约肌成形术２例，憩室切除１例，乳头成形术１例。结果近远期疗效满意，无复发及并发症。结论憩室－括约肌联合成形术既简单、安全、有效，又保持生理通道是治疗壶腹旁憩室的可取术式。

Objective To provide a better surgical method for periampullary diverticulum, its teraninology and typing,and some experience in its diagnosis. Method In 11 cases of recurrent cholangitis or (and) pancreatitis resulting from periampullary diverticula juxtaampullary diverticula was observed in 9,intraampullary diverticulum in 1, and ampullocele in 1.All patients underwent elective operation including combined diverticulosphincteroplasty(7 cases),diverticulectomy with sphincteroplasty(2),diverticulectomy (1), and papilloplasty(1). Result The perioperative and longterm results were excellent.There were no recurrence and morbidity. Conclusion The combined diverticulosphincteroplasty is simpl,safe,effective for the treatment of juxtaampullary diverticula.