中华消化内镜杂志
中華消化內鏡雜誌
중화소화내경잡지
Chinese Journal of Digestive Endoscopy
2015年
7期
457-461
,共5页
胆道测压%十二指肠乳头旁憩室%胰胆管造影术,内窥镜逆行%胆总管结石%Oddi括约肌压力%胆管内压力
膽道測壓%十二指腸乳頭徬憩室%胰膽管造影術,內窺鏡逆行%膽總管結石%Oddi括約肌壓力%膽管內壓力
담도측압%십이지장유두방게실%이담관조영술,내규경역행%담총관결석%Oddi괄약기압력%담관내압력
Biliary manometry%Juxta-papilary duodenal diverticulum%Cholangiopancreatography,endoscopic retrograde%Choledocholithiasis%Sphincter of Oddi pressure%Common bile duct pressure
目的 探讨十二指肠乳头旁憩室对胆总管结石形成及取石术后胆道压力的影响.方法 选择天津市南开医院微创外科中心201 1年5月至2014年3月成功行胆道测压和十二指肠镜诊疗的97例胆总管结石患者,根据是否伴有十二指肠乳头旁憩室分为观察组(伴十二指肠乳头旁憩室)52例和对照组(不伴十二指肠乳头旁憩室)45例,对比分析2组经内镜乳头括约肌切开术(EST)术前及取石后胆道压力.结果 EST术前观察组Oddi括约肌基础压明显高于对照组[(84.8±26.1)mmHg比(75.5±14.6)mmHg,P＜0.05](1mmHg =0.133 kPa),取石后观察组Oddi括约肌基础压亦明显高于对照组[(19.8±14.2)mmHg比(15.9±9.8)mmHg,P＜0.05];EST术前及取石后观察组胆总管内压均高于对照组,但差异无统计学意义(P＞0.05).出院后1个月随访时,有81例患者再次行胆道测压检查(观察组45例、对照组36例),观察组Oddi括约肌基础压仍明显高于对照组[(34.8±17.1) mmHg比(29.6±15.3) mmHg,P＜0.05],胆总管内压亦明显高于对照组[(19.9±11.2) mmHg比(17.1±13.1)mmHg,P＜0.05].结论 十二指肠乳头旁憩室的存在,增加了胆总管和Oddi括约肌的压力,促进了胆石的形成.
目的 探討十二指腸乳頭徬憩室對膽總管結石形成及取石術後膽道壓力的影響.方法 選擇天津市南開醫院微創外科中心201 1年5月至2014年3月成功行膽道測壓和十二指腸鏡診療的97例膽總管結石患者,根據是否伴有十二指腸乳頭徬憩室分為觀察組(伴十二指腸乳頭徬憩室)52例和對照組(不伴十二指腸乳頭徬憩室)45例,對比分析2組經內鏡乳頭括約肌切開術(EST)術前及取石後膽道壓力.結果 EST術前觀察組Oddi括約肌基礎壓明顯高于對照組[(84.8±26.1)mmHg比(75.5±14.6)mmHg,P＜0.05](1mmHg =0.133 kPa),取石後觀察組Oddi括約肌基礎壓亦明顯高于對照組[(19.8±14.2)mmHg比(15.9±9.8)mmHg,P＜0.05];EST術前及取石後觀察組膽總管內壓均高于對照組,但差異無統計學意義(P＞0.05).齣院後1箇月隨訪時,有81例患者再次行膽道測壓檢查(觀察組45例、對照組36例),觀察組Oddi括約肌基礎壓仍明顯高于對照組[(34.8±17.1) mmHg比(29.6±15.3) mmHg,P＜0.05],膽總管內壓亦明顯高于對照組[(19.9±11.2) mmHg比(17.1±13.1)mmHg,P＜0.05].結論 十二指腸乳頭徬憩室的存在,增加瞭膽總管和Oddi括約肌的壓力,促進瞭膽石的形成.
목적 탐토십이지장유두방게실대담총관결석형성급취석술후담도압력적영향.방법 선택천진시남개의원미창외과중심201 1년5월지2014년3월성공행담도측압화십이지장경진료적97례담총관결석환자,근거시부반유십이지장유두방게실분위관찰조(반십이지장유두방게실)52례화대조조(불반십이지장유두방게실)45례,대비분석2조경내경유두괄약기절개술(EST)술전급취석후담도압력.결과 EST술전관찰조Oddi괄약기기출압명현고우대조조[(84.8±26.1)mmHg비(75.5±14.6)mmHg,P＜0.05](1mmHg =0.133 kPa),취석후관찰조Oddi괄약기기출압역명현고우대조조[(19.8±14.2)mmHg비(15.9±9.8)mmHg,P＜0.05];EST술전급취석후관찰조담총관내압균고우대조조,단차이무통계학의의(P＞0.05).출원후1개월수방시,유81례환자재차행담도측압검사(관찰조45례、대조조36례),관찰조Oddi괄약기기출압잉명현고우대조조[(34.8±17.1) mmHg비(29.6±15.3) mmHg,P＜0.05],담총관내압역명현고우대조조[(19.9±11.2) mmHg비(17.1±13.1)mmHg,P＜0.05].결론 십이지장유두방게실적존재,증가료담총관화Oddi괄약기적압력,촉진료담석적형성.
Objective To explore the impact of juxtapapilary duodenal diverticulum on the formation of choledocholithiasis and biliary manometry after surgery.Methods The clinical data of 97 patients with common bile duct stones who successfully underwent ERCP and biliary manometry treatment from May 2011 to March 2014 were retrospectively analyzed.Ninty-seven common bile duct stone patients were divided to two groups,that is,52 cases of juxta-papilary duodenal diverticulum (experimental group) and 45 cases without juxta-papilary duodenal diverticulum (control group).The biliary manometric results before and after EST of both groups were compared.Results The basal pressure of sphincter Oddi of the experimental group before EST [(84.8 ± 26.1) mmHg] was higher than that of the control group before EST [(75.5 ± 14.6) mmHg] (P ＜ 0.05,1 mmHg =0.133 kPa);and that after EST was also higher than that of the control group after the operation[(19.8 ± 14.2)mmHg VS (15.9 ± 9.8)mmHg,P ＜ 0.05].The biliary pressure of common bile duct stone patients with JPD was higher than those without JPD before and after EST but with no significant difference(P ＞ 0.05).The biliary manometry was performed in 81 patients after one month and it was found that the basal pressure of sphincter Oddi of experimental group was still higher than that of the control group [(34.8 ± 17.1) mmHg VS (29.6 ± 15.3)mmHg,P ＜ 0.05].The biliary pressure of common bile of the experimental group was higher than that of the control group [(19.9 ± 11.2) mmHg VS (17.1 ± 13.1)mmHg,P ＜0.05].Conclusion The existence of juxtapapilary duodenal diverticulum increases the pressure of common bile duct and Oddi sphincter and leads to CBD stones.
