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目的 :探讨十二指肠乳头及周围病变与胆总管结石形成的关系 ,为胆总管结石的发生提供有效合理的预防措施。方法 :5 0 0余例内镜下逆行性胰胆管造影病例 ,确诊为胆总管结石并伴有十二指肠乳头及周围病变的病人共 10 7例 ,统计各种病变所占比例。结果 :10 7例胆总管结石病人 ,其中伴十二指肠降段憩室为 4 9例(占 4 5 .79% ) ,乳头及周围炎 31例 (占 2 8.97% ) ,乳头及周围癌 17例 (占 15 .89% ) ,胆道畸形 6例 (占5 .6 1% ) ,Oddi括约肌功能异常 4例 (占 3.74 % )。结论 :十二指肠降段憩室与胆总管结石的形成密切相关 ,十二指肠镜检查是确诊憩室最有效的方法。对十二指肠乳头及周围病变的及时处理是预防胆总管结石发生的重要措施之一。
Objective: To investigate the relationship between duodenal papilla and surrounding lesions and the formation of common bile duct stones and provide effective and reasonable preventive measures for the occurrence of common bile duct stones. Methods: More than 500 cases of endoscopic retrograde cholangiopancreatography, 107 cases diagnosed as choledocholithiasis accompanied with duodenal papilla and peripheral lesions were collected, and the proportion of various lesions was calculated. Results: Of 107 patients with choledocholithiasis, 49 cases (45.79%) had diverticula with duodenal descending segment, 31 cases (28.97%) had nipple and peri-inflammation, 17 (15.89%), 6 cases of biliary tract malformations (5.16%) and 4 cases of dysfunction of Oddi sphincter (3.74%). Conclusion: The descending duodenal diverticulum is closely related to the formation of common bile duct stones. Duodenoscopy is the most effective method to diagnose diverticulum. Duodenal papilla and the surrounding lesions in time to deal with the prevention of common bile duct stones is one of the important measures.