十二指肠乳头旁憩室致梗阻性黄疸的诊治
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胡国潢

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The diagnosis and treatment of obstructive jaundice caused by peripapillary duodenal diverticulum
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    目的: 探讨十二指肠乳头旁憩室与梗阻性黄疸的关系。方法: 回顾分析十二指肠乳头旁憩室致梗阻性黄疸25例患者的临床资料。结果: 25例均经内镜逆行胰胆管造影(ERCP)检查确诊,其中手术治疗20例,术式均为胆总管探查、T管引流、毕II式胃大部分切除术、旷置十二指肠,术后恢复均良好;非手术治疗5例,虽均于症状消退后出院,但随访均出现症状反复发作。结论: 十二指肠乳头旁憩室可致梗阻性黄疸,ERCP 检查可以明确诊断,治疗上均应采用手术治疗,胆总管探查、T管引流、毕II式胃大部分切除十二指肠旷置术,是简单、合理、安全、有效的术式。

    Abstract:

    Abstract:Objective:To investigate the relationship between peripapillary duodenal diverticulum and obstructive jaundice, and the diagnosis and treatment for this clinical entity. Methods:The clinical data of 25 cases of obstructive jaundice caused by peripapillary diverticulum were retrospectively reviewed. Results:All cases were diagnosed definitively by endoscopic retrograde cholangiopancreatography(ERCP). 20 cases underwent choledochostomy with T-tube drainage and subtotal gastrectomy (Billroth II) and recovered, and 5 cases were cured by nonoperative therapy and discharged asymptomatically, but followup showed they had recurrent attacks of symptoms. Conclusions:Obstructive jaundice caused by peripapillary diverticulum can be definitively diagnosed by ERCP, and should be treated by choledochostomy, T tube drainage and subtotal gastrectomy(Billroth II), which is a simple, rational, safe and effective surgical procedure.

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胡国潢,段炼,周军,汤恢焕.十二指肠乳头旁憩室致梗阻性黄疸的诊治[J].中国普通外科杂志,2006,15(3):16-220.
DOI:10.7659/j. issn.1005-6947.2006.03.015

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  • 在线发布日期: 2006-03-25