共同胆管进入十二指肠球和胃的异宫开口及其重要性
Ümit Karabulut1, Ali Üzel1, Ramazan Yolaçan1
1Department of Gastroenterology, Dicle University, Faculty of Medicine, Diyarbakır, Turkey.
Archives of Iranian medicine
|August 5, 2023
概括
普通胆道 (CBD) 的子宫外开口很少见,通常与胃肠问题有关. 对这种异常的内镜治疗取得了有限的成功,这凸显了管理这种疾病的挑战.
科学领域:
- 胃肠病学 胃肠病学
- 肝病学 肝病学是一种肝病学.
- 手术解剖学手术解剖学
背景情况:
- 普通胆道 (CBD) 的宫外开口是一种极其罕见的先天性异常.
- 它的临床意义和管理挑战仍未得到充分定义.
研究的目的:
- 为了描述诊断出CBD外宫开口的患者.
- 评估这种罕见疾病的临床,实验室和成像特征.
- 评估内镜逆行胆血管细胞学 (ERCP) 在诊断和管理中的有效性.
主要方法:
- 在第三级医疗中心 (2008年10月 - 2020年12月) 对外宫CBD开口患者的回顾性分析.
- 包括临床,实验室,内镜和胆血管学数据.
- 治疗干预措施的评估,特别是ERCP的结果.
主要成果:
- 在3872名患者中,在0.74%的患者中发现了宫外CBD开口,主要是老年男性 (平均年龄62岁).
- 之前胆囊切除术 (48%) 和复发性急性胆道炎 (69%) 的高患病率.
- 经常与胃潰瘍 (45%) 和十二指腸形 (72%) 相關.
- 最常见的开口部位是十二指肠的第一部分 (93%).
- 所有患者都表现出胆管扩张和特征性的CBD缩小;89%的人有胆结石.
- 气球扩张用于石头/泥提取的成功率很低 (27%).
结论:
- 宫外CBD开口经常与并发的胃肠病理和胆道疾病有关.
- 内镜干预,如气球扩张,在这些患者的胆固醇胆病等并发症管理方面表现出有限的成功.
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