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目的探讨十二指肠乳头周围憩室在胆总管结石发病中的作用。方法回顾分析我院近5年来行逆行胰胆管造影术(ERCP)检查的878例患者,其中发现十二指肠乳头周围憩室者128例(憩室组),未发现憩室者750例(非憩室组)。分析比较2组患者年龄、胆总管结石的发病率、复发率方面的差异。结果ERCP检出十二指肠乳头周围憩室128例,占14.58%。憩室组平均年龄64.8岁,明显高于非憩室组54.2岁(P<0.01)。憩室组胆总管结石检出率为66.4%,非憩室组为41.3%(P<0.001)。憩室组胆总管结石复发率为24.7%,非憩室组为11.9%(P<0.01)。结论十二指肠乳头周围憩室患者胆总管结石的发病率、复发率显著增高,十二指肠乳头周围憩室是胆总管结石形成的病因之一,也是胆总管结石复发的重要因素。
Objective To investigate the role of diverticulum around the duodenal papilla in the pathogenesis of common bile duct stones. Methods A retrospective analysis was performed on 878 patients who underwent retrograde cholangiopancreatography (ERCP) in our hospital in the past 5 years. Among them, 128 cases of diverticulum around duodenal papilla (diverticulum group) and 750 cases of no diverticulum were found ). Analysis of two groups of patients age, common bile duct stones incidence and recurrence rate differences. Results ERCP detected 128 cases of duodenal papillary diverticulum, accounting for 14.58%. The average age of diverticular group was 64.8 years, significantly higher than that of non-diverticulum group 54.2 years (P <0.01). In the diverticula group, the prevalence of common bile duct stones was 66.4% and that in the non-diverticula group was 41.3% (P <0.001). The recurrence rate of choledocholithiasis was 24.7% in diverticular group and 11.9% in non-diverticulum group (P <0.01). Conclusion The incidence and recurrence rate of choledocholithiasis in patients with duodenal papillary diverticula are significantly increased. Diverticulum around duodenal papilla is one of the causes of choledocholithiasis and an important factor for the recurrence of common bile duct stones.