Objective To study the clinical diagnosis and treatment of juxtapapillary duodenal diverticula with biliary deseases.
Methods Eighteen duodenal diverticulum treated in our department in recent 5 years were retrospectivly analyzed, especially investigated the postcholecystectomy cases whose symptoms were continuing existence after operatoins. Articles about the surgical treatment were reviewed.
Results The total of 18 duodenal diverticulum with 17 cases of juxtapapillary duodenal diverticulum were included in this study. The ages of 12 cases were over 50 years old. Sixteen cases(88.89%) presented biliary stones. Seven cases once had performed cholecystectomy or cholecystectomy plus choledochotomy,but symptoms persisted after operations. The duodenal diverticulum were found by endoscopic retrograde cholangiopancreatography (ERCP) and hypotonic duodenography. Sixteen patients underwent surgical treatment with good effect.
Conclusion The juxtapapillary duodenal diveticula has the close relationship with biliary stones. ERCP and hypotonic duodenogrphy are the most reliable methods to get the correct diagnosis. In case of recurrent common bile duct stones after operations or persisting billiary symptoms after cholecystectomy, the coexistence of juxtapapillary duodenal diverticulum should be ruled out. The surgical treatment is only considered for the duodenal diverticulum with complication.
Citation：
CHENG Nansheng,XIONG Xianze,PENG Qifang.. JUXTAPAPILLARY DUODENAL DIVERTICULA AND BILIARY DISEASES (REPORT OF 18 CASES). CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2001, 8(3): 173-175. doi:
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卢木发，郑国勤，熊浩.十二指肠憩室内溃疡的诊断 〔J〕. 中外医用放射技术，1998； 2(2)∶88.
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Lobo DN, Balfour TW, Iftikhar SY, et al. Periampullary diverticula and pancreaticobiliary disease 〔J〕. Br J Surg, 1999； 86(5)∶588.
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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.
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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.
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Kennedy RH, Thompson MH. Are duodenal diverticula associated with choledocholithiasis 〔J〕？ Gut, 1988； 29(7)∶1003.
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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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| 7. |
Lotveit T, Skar V, Osnes M. Juxtapapillary duodenal diverticula 〔J〕. Endoscopy, 1988； 20(Suppl 1)∶175.
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| 8. |
Fellbaum Juxtapapillary duodenal diverticulumpathologic findings 〔J〕. Wien Klin Wochenschr, 1987； 99(14)∶502.
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| 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.
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| 10. |
石景森，李发智，王林等.十二指肠憩室的外科治疗 〔J〕.临床外科杂志，1995； 3(5)∶241.
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| 11. |
Kaminsky HH. Thompson WR, Davis B. Extended sphincteroplasty for juxtapapillary duodenal diverticulum 〔J〕. Surg Gynecol Obster, 1986； 162(3)∶280.
|
- 1. 卢木发，郑国勤，熊浩.十二指肠憩室内溃疡的诊断 〔J〕. 中外医用放射技术，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，李发智，王林等.十二指肠憩室的外科治疗 〔J〕.临床外科杂志，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.
