复发胆总管结石伴随十二指肠乳头疾病的分析

摘要/Abstract

摘要：

目的：观察和分析复发胆总管结石伴随的十二指肠乳头疾病。方法：回顾性分析2018年1月1日至2020年6月30日我院因胆总管结石行内镜逆行胰胆管造影（endoscopic retrograde cholangiopancreatography, ERCP）取石且具有原始乳头的614例病人资料。结果：20例曾行胆总管探查取石术病人为复发胆总管结石组。按年龄、性别匹配20例无胆道手术或介入治疗史病人为初发胆总管结石组。复发胆总管结石组伴每种十二指肠乳头疾病的数量均高于初发胆总管结石组。乳头旁憩室9例比5例,乳头过长10例比4例,乳头炎2例比0,萎缩性乳头炎4例比1例,但差异无统计学意义。复发胆总管结石组伴有十二指肠乳头疾病比例较初发胆总管结石组高,正常乳头为3例比12例,差异有统计学意义（P=0.008）。结论：复发胆总管结石病人伴十二指肠乳头疾病比例高,原因有待进一步研究。

关键词:复发,胆总管结石,十二指肠乳头疾病

Abstract:

ObjectiveTo observe and analyze the duodenal papilla diseases associated with recurrent choledocholithiasis.MethodsA total of 614 patients with choledocholithiasis who had been treated with endoscopic retrograde cholangiopancreatography and without endoscopy or surgery of duodenal papilla were analyzed retrospectively from January 1, 2018 to June 30, 2020 in our hospital.ResultsTwenty patients with common bile duct stone extraction were studied as recurrent choledocholithiasis group, and 20 patients without biliary surgery or intervention were as initial choledocholithiasis group matched according to the age and gender. The number of patients with each duodenal papilla diseases in recurrent group were more than those in initial group. Parapapillary diverticulum was 9vs. 5, long nipple 10vs. 4, duodenal papillitis 2vs. 0, atrophic papillitis 4vs. 1 in both groups without statistically significant differences. There were more patients with duodenal papilla diseases in recurrent group than those in initial group. Normal nipple was 3 cases in recurrent group and 12 cases in initial group (P=0.008) with statistically significant difference.ConclusionsMore patients with recurrent choledocholithiasis had duodenal papilla disease and further studies are required for the mechanism of duoneal papilla disease associated with choledocholithiasis.

Key words:Recurrent,Choledocholithiasis,Duodenal papilla disease

中图分类号:

R657.42

边大鹏, 冯秋实. 复发胆总管结石伴随十二指肠乳头疾病的分析[J]. 外科理论与实践, 2020, 25(06): 477-480.

BIAN Dapeng, FENG Qiushi. Analysis of duodenal papilla diseases associated with recurrent choledocholithiasis[J]. Journal of Surgery Concepts & Practice, 2020, 25(06): 477-480.

图/表2

十二指肠乳头形态	复发胆总管结石组（n=20）	初发胆总管结石组（n=20）	P值
乳头旁憩室	9（45）	5（25）	0.323
乳头过长	10（50）	4（20）	0.096
乳头炎	2（10）	0	0.487
萎缩性乳头炎	4（20）	1（5）	0.342
正常乳头	3（15）	12（60）	0.008

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