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目的探讨Lemmel综合征的诊治方法。方法对135例Lemmel综合征患者的临床资料进行总结。结果 135例患者经十二指肠镜下逆行胰胆管造影及十二指肠低张造影检查确诊,78例(57.8%)初发及25例(18.5%)2次发作者采用内科治疗症状消失,3次及以上反复发作憩室炎者12例(8.9%)憩室位于十二指肠乳头外2cm者行憩室切除或憩室内翻缝合术,18例(13.3%)患者乳头位于憩室内或距憩室2cm范围内行胆总管空肠Roux-en-Y吻合术,2例(1.5%)反复发作胆管炎患者行胆总管十二指肠吻合术,术后均恢复顺利,无复发及明显不适。结论经十二指肠镜逆行胰胆管造影及十二指肠低张造影是诊断Lemmel综合征较好方法,内科治疗、憩室切除或内翻缝合、胆总管空肠Roux-en-Y吻合术等是对Lemmel综合征行之有效的治疗方法。
Objective To investigate the diagnosis and treatment of Lemmel’s syndrome. Methods The clinical data of 135 patients with Lemmel syndrome were summarized. Results 135 patients were confirmed by duodenoscopic retrograde cholangiopancreatography and duodenal low contrast radiography. 78 cases (57.8%) were initially diagnosed and 25 cases (18.5%) were secondary exacerbated by medical therapy , Three or more episodes of repeated episodes of diverticulitis in 12 patients (8.9%) diverticulum is located in the duodenal papillae 2cm diverticulum diverticulum or diverticulum surgery, 18 cases (13.3%) of the nipple in the diverticulum or diverticulum Roux-en-Y anastomosis of choledochojejunostomy was performed in 2 cm. Two cases (1.5%) of recurrent cholangitis patients underwent choledochojejunostomy. All patients recovered smoothly and had no recurrence and obvious discomfort. Conclusions The diagnosis of Lemmel’s syndrome by duodenoscopic retrograde cholangiopancreatography and duodenal low contrast radiography is a good method, medical treatment, diverticulum resection or varus suture, Roux-en-Y anastomosis of the common bile duct is Effective treatment of Lemmel syndrome.