摘要
目的探讨不同术式处理十二指肠乳头旁憩室的远期疗效。方法回顾性分析1982年4月～2001年10月我院治疗的86例合并胆胰疾病的十二指肠乳头旁憩室各种手术方式的远期胆管炎发生率（寿命表法）。结果治疗胆胰疾病而未处理憩室45例，胆管空肠Roux-en-Y吻合术9例，胃大部切除、胃空肠吻合术11例，憩室敞开联合Oddi括约肌成形术13例，其5年胆管炎发生概率分别为52．0％、40．0％、75．0％和66．7％，其他术式8例；各种处理方式其5年胆管炎发生率差异无显著性（x^2=1．49，P=0．8287）。结论无乳头狭窄的乳头旁憩室，仅须治疗胆胰疾病，可暂时不处理憩室；若术后出现胆管炎而无法用胆道疾病解释，根据病人的具体情况和医生的临床经验，采取的个体化手术治疗方案，其5年胆管炎发生率无明显差异。
Objective To study the long-term effect of different surgical procedures for juxtapapillary duodenal diverticula accompanying biliopancreatic diseases. Methods The study included 86 cases of juxtapapillary duodenal diverticula accompanying biliopancreatic diseases treated with different operations from April 1982 to October 2001. The 5-year incidence of postoperative cholangitis was retrospectively analyzed using the life table method. Results There were 45 cases of treatment of biliopancreatic diseases without management of the diverticula, 9 cases of Roux-en-Y choledochojejunostomy, 11 cases of subtotal gastrectomy with gastrojejunostomy （Billroth 11 ） , and 13 cases of sphincteroplasty, with their incidences of cholangitis in 5 years being 52.0% , 40.0% , 75.0% , and 66.7% , respectively. Other procedures were carried out in 8 cases. There was no statistically significant difference in incidences of cholangitis in 5 years among these procedures （X^2 = 1.49,P = 0. 8287 ）. Conelusions Management of juxtapapillary duodenal diverticula is not required in patients without the stenosis of the papilla. If postoperative cholangitis cannot be explained with biliary diseases, surgical procedures should be performed depending on the patient＇ s individual condition and the surgeon＇ s experience. The incidences of cholangitis in 5 years among these procedures are not significantly different.
出处
《中国微创外科杂志》
CSCD
2006年第2期93-94,共2页
Chinese Journal of Minimally Invasive Surgery
关键词
十二指肠乳头旁憩室
胆胰疾病
疗效评价
Juxtapapillary duodenal diverticulum
Biliopancreatic disease
Evaluation of curative effect
