十二指肠乳头旁憩室与胆石病关系的探讨

目的探讨十二指肠乳头旁憩室(juxta-papillaryduodenaldiverticulum,JPD)与胆石病的关系。方法回顾性分析2003年1月~2004年12月期间381例行内窥镜逆行胰胆管造影(en-doscopicretrogradecholangiopancreatography,ERCP)的病例,比较胆石病组与非胆石病组、胆管结石病组与胆囊并胆管结石病组JPD发生率的差别;并记录憩室的位置。结果胆石病组JPD发生率为24.54%(66/269),非胆石病组JPD发生率为8.93%(10/112),其差别有显著统计学意义(P<0.01);胆管结石病组的JPD发生率为21.48%(32/117),胆囊并胆管结石病组的JPD发生率为33.33%(30/90),其差别有统计学意义(P<0.05)。结论胆石病的存在与JPD的存在相关,JPD的存在可能是胆石病的原因之一,胆管括约肌受累及可能是机制之一。JPD与不同部位、不同性质结石发生的相关性需要进一步研究。

Relationship between juxta-papillary duodenal diverticulum and cholelithiais

Objective To study the relationship between juxta-papillary duodenal diverticulum and cholelithiasis.Methods The data of 381 cases subject to ERCP examination during Jan. 2003 to Dec. 2004 were analyzed retrospectively. The incidence of JPD was compared between the group with cholelithiasis and without cholelithiasis, and between the group with choledocholithiasis and choledocholithiasis combinded with gall stone. The position of JPD was registered.Results There was significant difference in the incidence of JPD ( P < 0.01 ) between the group with cholelithiasis ( 24.54 % , 66/269) and without cholelithiasis ( 8.93 % , 10/112). The incidence of JPD showed significant difference ( P < 0.05 ) between the group with choledocholithiasis and choledocholithiasis combinded with gall stone. Most of JPD located to the up or left side of the papilla, or intradiverticular papilla.Conclusion The occurrence of cholelithiasis correlates with JPD. JPD may be one of causes for cholelithiasis. The involved sphincter of bile duct may be one of the mechanisms. The relationship between JPD and the occurrence of different stones in different places must be study ulteriorly.