十二指肠乳头旁憩室伴缩窄性乳头炎24例临床分析

目的：探讨十二指肠乳头憩室与窄窄性乳头炎的关系及其治疗情况。方法：分析经术前，术中诊断明确的十二指肠乳头旁憩室伴缩窄性乳头炎24例的临床特点及诊断治疗。采用上消化道钡餐造影，逆行胰胆管造影，核素扫描及手术探查等多可明确诊断，本组24例中手术治疗18例，其中行胆总管探查，Oddi括约肌切开成形8例，扩约肌成形后加行憩室敝开成形3例，行胆总管十二指肠或十二指肠空肠吻合3例，行胃大部切除毕Ⅱ氏吻合旷置术1例，行憩室行除，括约肌切开置支架1列，未予特殊处理2例。结果：本组在乳头切开成形时加行憩室敝开成形术，近，远期疗效满意，无复发及并发症，结论：缩窄性乳头炎与十二指肠憩室有密切关系，胆总管探查后行十二指肠乳头切开成形合并憩室敞开成形治疗效果好。

Clinical analysis of 24 cases of juxtapapillary duodenal diverticula with stenosing papillo-odditis

Objective The aim of this study was to investigate the relationship between juxtapapillary duodenal diverticula (JDDs)and stenosing papillo odditis,and the diagnosis and treatment for this clinical entity.Methods Patients underwent upper gastrointestinal radiography,ERCP, and radionuclide scan. 18 cases were treated with operation,8 cases underwent sphincteroplasty,3 with combined diverticulo sphincteroplasty, 3 with choledochoduodenostomy or choledochojejunostomy,1 with gastrojejunostomy,1 case with diverticulectomy.Results Sphincteroplasty effects a good result for coexistant JDDs and stenosing papilloodditis. There were no recurrence and complication after the combined diverticulo sphincteroplasty. Conclusion There was a causal relation between JDDs and stenosing papillo odditis. Effective treatment was achieved by combining sphincteroplasty with diverticulo sphincteroplasty.