十二指肠乳头旁憩室与胆结石的关系(附92例分析)

Relationship between duodenal para-papillary diverticula and biliary calculi(Analysis of 92 cases)

目的探讨十二指肠乳头旁憩室对胆结石发病的影响。方法回顾性分析广州市番禺中心医院行逆行胰胆管造影检查发现十二指肠憩室患者92例的临床资料,分析十二指肠憩室与胆结石的关系。结果在接受ERPD的462例受检者中,19.9%h患者发现有十二指肠憩室,平均年龄61.8岁,其中72例十二指肠憩室合并胆结石,发生率为78.3%(72/92),而同期检查的非十二指肠憩室受检者中,97例合并胆结石,占26.2%(97/370)。十二指肠憩室中,乳头旁憩室合并胆结石的发生率为88.06%(59/67),十二指肠乳头周围憩室合并胆结石的发生率32%(8/25)。乳头旁憩室患者中结石中胆色素结石结石占54.17%(26/48)、胆固醇结石占45.83%(22/48),而乳头周围憩室患者中结石中胆色素结石结石占28%(7/25)、胆固醇结石占72%(18/25)。结论十二指肠乳头旁憩室患者胆结石发病率较十二指肠乳头周围憩室患者及非憩室患者有显著增高。

Objective To investigate the influence of duodenal diverticulum on the formation of biliary calculi. Methods A data of consecutive patients undergoing endoscopic retrograde eholangiopancreatography （ERCP） from Jan 2002 to Jan 2009 were analyzed retrospectively. The relationship between duodenal diverticulum and biliary calculi was investigated and analyzed. Results Ninety-two cases with duodenal diverticulum were found in the examination of a total 462 subjects, including 67 cases of juxtapapillary duodenal diverticulum （JDD） and 25 cases of periampullary diverticula. Of these 92 cases, 72 were complicated with biliary calculi （78.3%, 72 / 92）, in which JDD was complicated in 59 cases （88.06%, 59/67）, periampullary diverticulum was in 8 cases （32%, 8/32）. However, 97 cases were found biliary calculi in the same period of non-duodenal diverticulum subjects （26.2%, 97/370）. The incidence of bile pigment stone in JDD was 54.17% （26/48）, and that of cholesterol stone was 45.83% （22/48）. The incidence of bile pigment stone in periampullary diverticula was 28% （7/25）,and that of cholesterol stone was 72% （18/25）. Conclusion In our data of the ERCP examination, the patients of duodenal diverticulum had a higher incidence of gallstones as compared to those patients with non-duodenal diverticulum.