通过CT影像分析十二指肠乳头缘型憩室与胆总管扩张的相关因素

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目的:通过CT影像分析十二指肠乳头缘型憩室与胆总管扩张的相关因素。方法:回顾性分析上海市徐汇区大华医院经多层螺旋CT检查发现并经消化道造影或内窥镜逆行胆胰管造影术(ERCP)确诊的220例十二指肠憩室患者的临床资料。分析十二指肠乳头缘型憩室与胆总管接触、与胆总管接触长度及渗出与胆总管扩张的相关性。结果:220例患者共236个十二指肠憩室,其中,乳头缘型憩室152个,乳头上型憩室41个,乳头下型憩室28个,乳头水平外侧型憩室3个,憩室位于水平段12个。乳头缘型憩室与胆总管接触患者胆总管扩张发生率明显高于乳头缘型憩室与胆总管无接触患者[59.35%(73/123)比37.93%(11/29)],差异有统计学意义(n P<0.05);乳头缘型憩室与胆总管接触长度≥ 1.5 cm患者胆总管扩张发生率明显高于乳头缘型憩室与胆总管无接触患者和乳头缘型憩室与胆总管接触长度<1.5 cm患者[82.43%(61/74)比24.49%(12/49)和37.93%(11/29)],差异有统计学意义(n P<0.05);乳头缘型憩室见渗出患者胆总管扩张发生率明 显高于乳头缘型憩室未见渗出患者[10/11比52.48%(74/141)],差异有统计学意义(n P<0.05)。n 结论:十二指肠乳头缘型憩室与胆总管接触长度≥ 1.5 cm及十二指肠乳头缘型憩室见渗出患者易发生胆总管扩张。“,”Objective:To analyze the correlation factors between peripapillary duodenal diverticulum (PDD) and choledochectasia by CT scan.Methods:The clinical data of 220 patients with duodenal diverticulum detected by multi-slice spiral CT scan and confirmed by gastrointestinal angiography or endoscopic retrograde cholangiopancreatography (ERCP) in Dahua Hospital, Xuhui District of Shanghai City were retrospectively analyzed. The correlation of the PDD, the contact of common bile duct (CBD), length of contact and exudation with choledochectasia in patients with PDD were analyzed.Results:A total of 236 duodenal diverticulum were found in 220 patients. Among them, there were 152 PDD, 41 diverticulum located superior to the duodenal papilla, 28 diverticulum located inferior to the duodenal papilla, 3 diverticulum located lateral to the duodenal papilla, and 12 diverticulumlocated in the horizontal portion. The incidence of choledochectasia in patients with PDD contacted with CBD was significantly higher than that in patients with PDD not contacted with CBD: 59.35% (73/123) vs. 37.93% (11/29), and there was statistical difference (n P<0.05); the incidence of choledochectasia in patients with contact length of PDD and CBD ≥1.5 cm was significantly higher than that in patients without contact of PDD and CBD and patients with contact length of PDD and CBD <1.5 cm: 82.43% (61/74) vs. 24.49% (12/49) and 37.93% (11/29), and there was statistical difference (n P<0.05); the incidence of choledochectasia in PDD patients with exudation was significantly higher than that in PDD patients without exudation: 10/11 vs. 52.48% (74/141), and there was statistical difference (n P<0.05).n Conclusions:The patients with contact length of PDD and CBD ≥1.5 cm and patients with PDD combined with exudation could be prone to choledochectasia.
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