目的 探討十二指腸憩室尤其是乳頭旁憩室在并發膽道疾病時的臨床診治問題。
方法 對我院近5年收治的18例十二指腸憩室進行分析。總結了憩室合并膽管結石的臨床問題，尤其是膽囊膽管術后癥狀不消失，再發現十二指腸乳頭旁憩室，回顧了外科手術問題。
結果 十二指腸憩室18例，17例位于乳頭旁。2/3以上病例年齡大于50歲。16例(8889%)并發膽管結石，7例(3889%)曾行膽囊切除或膽總管切開取石、T管引流術，術后仍有癥狀，經十二指腸低張造影和／或ERCP檢查發現十二指腸乳頭旁憩室。16例行不同手術治療，效果良好。無并發癥，無死亡病例。
結論 十二指腸乳頭旁憩室與膽管結石關系密切； 十二指腸低張造影和ERCP檢查是確診本病可靠的方法； 當膽道術后仍有癥狀或反復發生膽總管色素性結石時，應行內鏡或十二指腸低張造影檢查，以除外十二指腸乳頭旁憩室之可能； 當憩室有合并癥發生時應考慮手術治療。
引用本文：
程南生,熊先澤,彭其芳. 十二指腸乳頭旁憩室與膽道疾病(附18例報告). 中國普外基礎與臨床雜志, 2001, 8(3): 173-175. doi:
復制
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Kimura W, Nagai H. No significant correlation between histologic changes of the papilla of vater and Juxtapapillary diverticulum. Special reference to the pathogenesis of gallstones 〔J〕. Scand J Gastroenterol, 1992； 27(11)∶951.
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Lotveit T, Skar V, Osnes M. Juxtapapillary duodenal diverticula 〔J〕. Endoscopy, 1988； 20(Suppl 1)∶175.
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石景森，李發智，王林等.十二指腸憩室的外科治療 〔J〕.臨床外科雜志，1995； 3(5)∶241.
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- 1. 盧木發，鄭國勤，熊浩.十二指腸憩室內潰瘍的診斷 〔J〕. 中外醫用放射技術，1998； 2(2)∶88.
- 2. Lobo DN, Balfour TW, Iftikhar SY, et al. Periampullary diverticula and pancreaticobiliary disease 〔J〕. Br J Surg, 1999； 86(5)∶588.
- 3. Vomo G, Manes G, Ragozzino A, et al. Periampullary extraluminal duodenal diverticula and acute pancreatitis:an underestimated etiological association 〔J〕. Am J Gastroenterol, 1996； 91(6)∶1186.
- 4. Nagakawa J, Kanno M. Ueno K, et al. Intrabiliary pressure measurement by duodenal pressure loading for the evaluation of duodenal parapapillary diverticulum 〔J〕. Hepatogastroenterology, 1996； 43(1)∶1129.
- 5. Kennedy RH, Thompson MH. Are duodenal diverticula associated with choledocholithiasis 〔J〕？ Gut, 1988； 29(7)∶1003.
- 6. Kimura W, Nagai H. No significant correlation between histologic changes of the papilla of vater and Juxtapapillary diverticulum. Special reference to the pathogenesis of gallstones 〔J〕. Scand J Gastroenterol, 1992； 27(11)∶951.
- 7. Lotveit T, Skar V, Osnes M. Juxtapapillary duodenal diverticula 〔J〕. Endoscopy, 1988； 20(Suppl 1)∶175.
- 8. Fellbaum Juxtapapillary duodenal diverticulumpathologic findings 〔J〕. Wien Klin Wochenschr, 1987； 99(14)∶502.
- 9. Iasu JP, Rocher L, Amouyal P, et al. Intraluminal duodenal diverticulum:radiological and endoscopoic ultrasonography findings of an unusual cause of acute pancreatitis 〔J〕. Eur Radiol, 1999； 9(9)∶1898.
- 10. 石景森，李發智，王林等.十二指腸憩室的外科治療 〔J〕.臨床外科雜志，1995； 3(5)∶241.
- 11. Kaminsky HH. Thompson WR, Davis B. Extended sphincteroplasty for juxtapapillary duodenal diverticulum 〔J〕. Surg Gynecol Obster, 1986； 162(3)∶280.
