Korean Journal of Gastrointestinal Endoscopy 2007;35(3): 152-158.
십이지장 유두 주위 게실 환자에서의 내시경 유두 괄약근 절개술에 대한 고찰: 게실 위치에 따른 분석 포함
윤현아·노명환·백양현·김영훈·유현승·이성욱·장진석·이종훈·한상영·최석렬
동아대학교 의과대학 내과학교실
Analysis of Endoscopic Sphincterotomy in Patients with Periampullary Diverticulum: according to the Location of the Diverticulum
Hyun Ah Yoon, M.D., Myung Hwan Roh, M.D., Yang Hyun Baek, M.D., Yung Hoon Kim, M.D., Hyun Seung Yoo, M.D., Sung Wook Lee, M.D., Jin Seok Jang, M.D., Jong Hun Lee, M.D., Sang Yung Han, M.D. and Seok Reyol Choi, M.D.
Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
Abstract
Background/Aims: Endoscopic sphincterotomy (EST) involves more complications and medical problems when a periampullary diverticulum (PD) is present. The data about EST for treating a small population of PD patients is controversial and any recent data is rare. The aim of this study is to evaluate the results of performing EST for a large population of PD patients. Methods: We retrospectively enrolled 178 patients with PD and 178 patients without PD and these patients underwent EST for removal of common bile duct (CBD) stones during the years 2003～2005 at Dong-A University Hospital. We classified PD patients, according to the location of the ampulla and diverticulum, into 3 groups and we considered removal of the CBD stones as success. Results: The success rates of EST in the two groups were similar: 91.0% in the PD group and 98.8% in the control group (p=0.0341). Failures were more frequently observed when the papilla was located inside of the diverticulum than for the other locations (p=0.0341). The complications cholangitis and pancreatitis after EST were similar for the two groups, but bleeding was more frequently observed in the PD group (p=0.0067). Conclusions: More skill for performing EST is needed to prevent bleeding in PD patients and it is more difficult to remove CBD stones when the papilla was located inside of the diverticulum. (Korean J Gastrointest Endosc 2007;35:152-158)
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