十二指肠乳头嵌塞胆总管结石的临床特点。

Jae Min Lee, Sang Hoon Lee, Ji Hyun Kim, Tae Suk Kim, Sung Hoon Chang, San Ha Kim, Jung Ho Lee, Chang Don Kang, Jin Myung Park
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引用次数: 0

摘要

背景/目的:在十二指肠乳头内嵌的胆结石需要紧急内镜切除。本研究比较了阻生乳头状结石(IPS)与无阻生胆总管结石的临床特征。方法:本研究分析了2017年至2023年的胆总管结石数据库,确定了IPS患者。比较IPS与非IPS的胆总管结石(NIPS)的临床特点。结果:共分析180例患者;45例为IPS。平均年龄63.9岁,IPS组以男性为主。选择性胆道插管成功率在IPS组和NIPS组之间具有可比性。多因素分析显示,IPS与胰腺炎(优势比[OR] 3.78, 95%可信区间[CI]: 1.17-12.17, p=0.026)、胆管穿透十二指肠壁体征(BPDS, OR 12.09, 95% CI: 3.92-37.33)相关,结论:IPS与胰腺炎、BPDS、急性化脓性胆管炎相关,而罐腹周围憩室、结石大小与IPS呈负相关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical Features of Impacted Common Bile Duct Stones at Duodenal Papilla.

Background/aims: Urgent endoscopic removal is required for gallstones impacted at the duodenal papilla. This study compared the clinical features of impacted papillary stones (IPS) with those of common bile duct stones without impaction.

Methods: This study analyzed a common bile duct stone database from 2017 to 2023, identifying patients with IPS. The clinical features of IPS were compared with those of common bile duct stones without IPS (NIPS).

Results: One hundred and eighty patients were analyzed; 45 had IPS. The mean age was 63.9 years, with a male predominance in the IPS group. The success rates of selective biliary cannulation were comparable between the IPS and NIPS groups. Multivariate analysis showed that IPS was associated with pancreatitis (odds ratio [OR] 3.78, 95% confidence interval [CI]: 1.17-12.17, p=0.026), bile duct penetrating duodenal wall sign (BPDS, OR 12.09, 95% CI: 3.92-37.33, p<0.001), and the presence of pus (OR 27.05, 95% CI: 4.92-148.85, p<0.001). The periampullary diverticulum (OR 0.28, 95% CI: 0.10-0.82, p=0.021) and the largest stone ≥10 mm (OR 0.31, 95% CI: 0.10-0.96, p=0.043) were inversely correlated with IPS.

Conclusions: IPS are associated with pancreatitis, BPDS, and acute suppurative cholangitis, whereas periampullary diverticulum and the stone size are inversely correlated with IPS.

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