十二指肠乳头旁憩室手术治疗46例分析

Surgical Treatment of Parapapillary Duodenal Diverticula:an Analysis of 46 Cases

目的 :探讨十二指肠乳头旁憩室手术治疗的适应证、方法及疗效。方法 ;回顾分析 1979年 2 0 0 2年间手术治疗的 4 6例乳头旁憩室患者的临床资料。结果 :4 6例中 ,憩室切除术 33例 ,憩室内翻缝合术 4例 ,BillrothⅡ式胃切除和 (或 )胆总管空肠Roux -en -Y吻合术 8例。憩室出血缝扎术 1例。全组共有 2 2例同时行胆道手术。术中损伤胆总管和主胰管各 1例 ,均经手术治疗后治愈。术后死亡 1例。全组 4 0例获得随访 ,36例术后症状完全消失 ,总治愈率 90 %。结论 :憩室切除术是治疗十二指肠乳头旁憩室的首选方法 。

Objective: To investigate the indications,methods and effectiveness of surgical treatment for the parapapillary duodenal diverticula (PDD).Methods: Clinical dada of 46 patients undergoing surgery from 1979 to 2002 were analyzed retrospectively.Results: Of the 46 cases, 33 were treated with diverticulectomies,and 4 with inversion of The diverticula,8 with Billroth Ⅱgastrectomy and/or Roux-en-Y choledochojejunostomy,1 with simple suture of the bleeding site.Common bile duct and pancreatrc duct were injured in 2 cases,and both were cured by surgical repairing and draining procedures.One patient died from kidney failure 5 days after invesion of the diverticulum. Fourty cases.were followed up , and the results were excellent in 36 cases.The overall cure rate was 90%.Conclusion: Removal of the diverticulum is the treatment of choice for most of the PDD patients. Billroth Ⅱgastrectomy and/or Roux-en-Y choledochojejunostomy are suggestive for the patients who are unsuitable for diverticulectomies.