- 期刊
The Relationship of Duodenal Juxtapapillary Diverticulum and Biliary Calculi: A Ten-year Observation at Endoscopic Retrograde Cholangiopancreatography
十二指腸乳頭旁憩室與膽道結石之關係：10年內視鏡逆行性膽胰管攝影術之觀察
摘要
In Taiwan, the prevalence of gallstone in younger persons is relatively higher than that of western countries. This prospective study was carried out for 10 years by collecting juxtapapillary diverticular patients to evaluate the relationship between juxtapapillary diverticulum and biliary stone formation by using endoscopic retrograde cholangiopancreatography (ERCP). Among 1444 symptomatic patients who underwent ERCP, biliary stone was found in 86.6% of diverticular patients versus 81.1% of non-diverticular ones (p=0.03). However, the percentage of biliary stone in diverticular patients was not significantly higher than in nondiverticular ones, either above or below the age of 40 (84.6% vs. 73.7%, P＞0.3; 86.8% vs. 84.0%, P=0.25, respectively). In the nondiverticular patients, the percentage of stone increased with age (73.7% under the age of 40 vs. 84.0% over, P＜0.001) and in female patients (80.4% vs. 66.9%, P＜0.001). In the diverticular patients, there were no age (84.6% vs. 86.8%) and sexual differences. To focus on the patients of bile duct stone only, the percentage of stone was not higher in diverticular patients. Analysing the location of the diverticulum at ampullary region, there was no positive relation between the presence of stone and the location of the diverticulum. We conclude that juxtapapillary diverticulum is an associated factor with stone formation in the biliary tract; however, in Taiwan, the diverticulum is not the only factor, especially in females.
並列摘要
In Taiwan, the prevalence of gallstone in younger persons is relatively higher than that of western countries. This prospective study was carried out for 10 years by collecting juxtapapillary diverticular patients to evaluate the relationship between juxtapapillary diverticulum and biliary stone formation by using endoscopic retrograde cholangiopancreatography (ERCP). Among 1444 symptomatic patients who underwent ERCP, biliary stone was found in 86.6% of diverticular patients versus 81.1% of non-diverticular ones (p=0.03). However, the percentage of biliary stone in diverticular patients was not significantly higher than in nondiverticular ones, either above or below the age of 40 (84.6% vs. 73.7%, P＞0.3; 86.8% vs. 84.0%, P=0.25, respectively). In the nondiverticular patients, the percentage of stone increased with age (73.7% under the age of 40 vs. 84.0% over, P＜0.001) and in female patients (80.4% vs. 66.9%, P＜0.001). In the diverticular patients, there were no age (84.6% vs. 86.8%) and sexual differences. To focus on the patients of bile duct stone only, the percentage of stone was not higher in diverticular patients. Analysing the location of the diverticulum at ampullary region, there was no positive relation between the presence of stone and the location of the diverticulum. We conclude that juxtapapillary diverticulum is an associated factor with stone formation in the biliary tract; however, in Taiwan, the diverticulum is not the only factor, especially in females.
延伸閱讀
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