十二指肠憩室与胆道结石关系的探讨

发布时间：2018-03-21 05:32

本文选题：十二指肠憩室　切入点：内镜　出处：《扬州大学》2014年硕士论文　论文类型：学位论文

【摘要】：[背景]十二指肠憩室在行内镜下逆行胰胆管造影术(endoscopic retrograde cholangio-pancreatography, ERCP)检出率约为3.2%-26%,目前研究报告对十二指肠憩室是否对胆管插管或者术后主要并发症有影响仍有一定争议。 [目的]探讨十二指肠憩室的存在与胆道结石关系,对ERCP胆管插管及对术后主要并发症的影响,并从侧面了解我院初期ERCP水平。 [方法]回顾性分析2010年1月至2012年1月期间,在我院行ERCP的179例患者,分析比较憩室组(A组)与非憩室(B组)患者的年龄,胆道结石发生率,胆结石发生部位、插管成功率及并发症。 [结果]179例患者中,憩室组59例,男性为30名,女性为29名,平均年龄为67岁。憩室伴发胆道结石达55例,其中原发性胆总管结石为8例。非憩室组120例,男性为57名,女性为63名,平均年龄为57岁。非憩室组胆道结石为92例,原发性胆总管结石为14例。原发性胆总管结石发生率两组分别为：13.56%和11.67%,两者有统计学差异(P=0.001)。憩室组插管成功率达91.53%(54/59),非憩室组达96.67%(116/120),插管成功率无统计学意义(91.53%VS96.67%, P=0.139, Fisher矫正后为0.158)。憩室组与非憩室组PEP发生率分别达：11.86%(7/59)及8.33%(10/120),两组之间PEP发生率无差别(11.86%VS8.33%,P=-0.574)。 [结论]十二指肠憩室的存在随年龄增大而发病率升高,憩室的存在与胆道结石发生相关,其对ERCP插管成功率及术后主要并发症无影响。
[Abstract]:[background] the detection rate of endoscopic retrograde cholangio-pancreatography (ERCP) in duodenal diverticulum is about 3.2-26. There is still some controversy about whether duodenal diverticulum has influence on bile duct intubation or major postoperative complications. [objective] to investigate the relationship between the existence of duodenal diverticulum and cholelithiasis, the influence of ERCP bile duct intubation and main postoperative complications, and to understand the level of ERCP in the early stage of our hospital. [methods] the age, incidence and location of cholelithiasis in group A (group A) and group B (non-diverticulum group) were analyzed retrospectively from January 2010 to January 2012 in 179 patients with ERCP in our hospital. Successful rate of intubation and complications. [results] among 179 patients, there were 59 cases in diverticulum group, 30 males and 29 females, with an average age of 67 years. There were 55 patients with cholelithiasis associated with diverticulum, including 8 patients with primary choledocholithiasis, 120 patients with non-diverticulum group and 57 patients with male choledocholithiasis. There were 63 females with an average age of 57 years. 92 cases of cholelithiasis were found in non-diverticulum group. There were 14 cases of primary choledocholithiasis. The incidence of primary choledocholithiasis in the two groups was: 13.56% and 11.67%, respectively. There was statistical difference between the two groups. The success rate of intubation in diverticulum group was 91.53 / 54 / 59, and that in non-diverticulum group was 96.67VS96.670.The success rate of intubation was not significantly different from that of non-diverticulum group. The incidence of PEP in the diverticulum group and the non-diverticulum group was 7 / 59 and 8.33 / 120, respectively. There was no difference in the incidence of PEP between the two groups. There was no difference between the two groups in the incidence of PEP. [conclusion] the incidence of duodenal diverticulum increases with age. The presence of duodenal diverticulum is related to the occurrence of cholelithiasis, and has no effect on the success rate of ERCP intubation and major postoperative complications.
【学位授予单位】：扬州大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R574.51;R575.62

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