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目的探讨异位胰胆管共同开口在内镜逆行胰胆管造影(ERCP)操作及胆胰疾病诊断和治疗中的意义。方法总结4年来1000例ERCP检查中发现的5例胰胆管共同通道开口异位部位和特点,以及异位乳头周围黏膜病变及胆胰病变特点。结果5例中乳头开口异位于胃窦部1例,十二指肠球部2例,十二指肠降部远段2例。5例中胆总管结石3例,胰管结石1例,胆胰正常1例;位于胃窦及十二指肠球部2例均有黏膜糜烂病变。结论胰胆管共同通道开口异位可能会影响乳头发现,但只要认真寻找,并不会影响ERCP检查。在有异位开口病人中,胆胰疾病发病率增加,乳头周围黏膜病变也增多。
Objective To investigate the significance of ectopic pancreaticobiliary duct common orifice in endoscopic retrograde cholangiopancreatography (ERCP) and the diagnosis and treatment of biliary and pancreatic diseases. Methods The ectopic sites and features of 5 common cholangiopancreatic duct common pathways found in 1000 cases of ERCP examination during 4 years were summarized, as well as the mucosal lesions around the ectopic papilla and the features of gallstone and pancreas. Results In 5 cases, the nipple was not located in the antrum, 1 case had duodenal bulb, 2 cases had duodenal bulb and 2 cases had distal descending part of duodenum. 5 cases of common bile duct stones in 3 cases, 1 case of pancreatic duct stones, bile and pancreatic normal in 1 case; located in the antrum and duodenal bulb in 2 cases have mucosal erosion lesions. Conclusions Ectopic pancreatic duct common duct opening may affect papillary findings, but as long as serious looking, will not affect the ERCP examination. In patients with ectopic opening, biliary and pancreatic disease increased incidence of mucocutaneous lesions also increased.