不同大小及类型壶腹周围憩室对胆道疾病发病情况的影响

Effects of different size and type of periampullary duodenal diverticula on the incidence of biliary tract diseases

目的统计分析不同大小及类型的壶腹周围憩室（PAD）对胆道疾病发病率的影响。方法回顾性分析2013年4月至2016年3月于天津市南开医院首次经内镜检查发现PAD的患者资料，统计其年龄、性别、胆胰疾病发病情况及PAD大小、类型与胆道疾病的关系。结果共纳入PAD患者1012例。按憩室大小分型，小憩室组急性胰腺炎的发病率（18．03％，97／538）高于大憩室组（10．78％，11／102）及中憩室组（12．90％，48／372），差异有统计学意义（P=0．024）；大憩室组急性胆管炎的发病率（46．08％，47／102）高于中憩室组（39．52％，147／372）及小憩室组（33．46％，180／538），差异有统计学意义（P=0．029）。不同类型PAD患者胆道疾病发生率差异无统计学意义（P〉0．05）。结论PAD的大小与胆道疾病的发生密切相关，而其类型对胆道疾病的发生影响并不显著。

Objective To analyze the effects of different size and type of periampullary diverticula （PAD） on the incidence of biliary tract diseases. Methods The data of patients with PAD, who were first diagnosed by endoscopic examination in Tianjin Nankai Hospital from April 2013 to March 2016 were collected, and the age, gender, morbidity of biliary tract diseases, and the relationship between the size and type of PAD with biliary tract diseases were analyzed. Results A total of 1 012 PAD patients were collected in the study. The rate of acute pancreatitis in patients with small PAD （ 18.03%, 97/538） was higher than that of patients with large PAD （10.78%, 11/102） and middle PAD （12.90%, 48/372）, and the difference was statistically significant（P=0. 024）. The rate of acute cholangitis in patients with large PAD （46. 08%, 47/102） was higher than that of patients with middle PAD （39. 52%, 147/372） and small PAD （33.46%, 180/538）, and the difference was statistically significant（P= 0. 029）. No significant differences were observed in the morbidity of common bile duct stones, acute pancreatitis and acute cholangitis among the different types of PAD （P〉 0. 05）. Conclusion The size of PAD is correlation with the incidence of biliary tract diseases, but the type of PAD has no significant impact for the incidence of biliary tract diseases.