摘要
目的 探讨十二指肠乳头旁憩室及其位置在经内镜逆行胰胆管造影临床应用中的意义.方法 回顾性分析2010年1月-2016年4月因不同适应证于浙江省东阳市人民医院肝胆外科施行经内镜逆行胰胆管造影术的475例患者的病例资料,比较各组患者在插管成功率及术后并发症方面的差异.计量资料以均数±标准差((x)±s)表示,组间比较采用t检验.计数资料以频数和百分数表示,组间比较采用x2检验或Fisher确切概率法.结果 本组475例施行经内镜逆行胰胆管造影术患者中合并十二指肠乳头旁憩室)者67例(14.11％),其中乳头位于憩室周围组38例(56.72％),乳头位于憩室内组29例(43.28％).十二指肠乳头旁憩室组第一次插管成功率较无十二指肠乳头旁憩室组低,差异具有统计学意义(P=0.022).在总插管成功率上,两者差异无明显统计学意义(P =0.086),十二指肠乳头旁憩室组经内镜逆行胰胆管造影术后胰腺炎、消化道出血发病率明显高于无十二指肠乳头旁憩室组(P=0.023,P=0.003).乳头位于憩室周围组第一次插管成功率、总插管成功率较乳头位于憩室内组高(P =0.002,P=0.001),两组在经内镜逆行胰胆管造影术后胰腺炎、消化道出血发病率之间差异无统计学意义(P=1.000,P=1.000).结论 十二指肠乳头旁憩室及其不同位置会对经内镜逆行胰胆管造影术造成一定的操作难度,并不同程度地影响术后并发症的发生.
Objective To evaluate the clinical significance of different localizations of juxtapaillary duodenal diverticula of patients with endoscopic retrograde cholangiopancreatography for pancreaticobiliare disease.Methods We studied patients in whom juxtapaillary duodenal diverticula was detected during endoscopic retrograde cholangiopancreatography form January 2010 to April 2016 in Department of Hepatobiliary Surgery,Dongyang People's Hospital of Zhejiang Province.The influence of juxtapaillary duodenal diverticula on the success rate of endoscopic retrograde cholangiopancreatography and the incidence of associated complications was analyzed.Measurement date were represented as ((x) ± s) comparison between the groups was analyzed by the t test.Count date were evaluated by the frequency and percentage,comparison between the groups was analyzed by the chisquare test or Fisher exact probability method.Results Juxtapaillary duodenal diverticula were present in 67 (14.11％) of the 475 patients undergoing endoscopic retrograde cholangiopancreatography for various indictions.Of the 67 patients,38 (56.72％) patients were peridiverticular papilla and 29 (43.28％) patients were intradiverticular papilla.The presence of cannulation success on first attempt was signicantly different between juxtapaillary duodenal diverticula group and non-juxtapaillary duodenal diverticula group(P =0.022),whereas the presence of c annulation success on total attempt was no-different between two groups(P =0.086).The presence of cannulation success on first attempt and total attempt was signicantly different between peridiverticular papilla group and intradiverticular papilla group(P =0.002,P =0.001).The presence of post-ERCP pancreatitis and bleed were more frequently in juxtapaillary duodenal diverticula group (P =O.023,P =0.003),but the different was non-signicantly between peridiverticular papilla group and intradiverticular papilla group (P =1.000,P =1.000).Conclusion Juxtapaillary duodenal diverticula detection rate and different location increase the difficulty of endoscopic retrograde cholangiopancreatography and maybe increase the presence of complications.
出处
《国际外科学杂志》
2017年第9期611-614,共4页
International Journal of Surgery
基金
浙江省金华市科学技术研究项目，Science and Technology Foundation of Jinhua City,Zhejiang Province
关键词
十二指肠疾病
憩室
手术后并发症
经内镜逆行胰胆管造影术
内镜治疗
Duodenal diseases
Diverticulum
Postoperative complications
Endoscopic retrograde cholangiopancreatography
Endoscopic therapy
