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담관 결석 발생과 재발에 있어 십이지장 팽대부 주위 게실과의 상관관계
김상균(Sang Gyun Kim),정재연(Jae Yeon Jeong),고주영(Ju Yeong Ko),이현근(Geum Nam Kim),김금남(Hyeon Geun Lee),조영기(Young Ki Cho) 대한영상의학기술학회 2010 대한영상의학기술학회 논문지 Vol.2010 No.-
Purpose : This study was designed to assess the ERCP findings of a juxtapapillary duodenal diverticulum and with even higher rate following subsequent reoperation. However, the factors contributing to recurrent stones have not well defined. Some authors have reported on association of juxtapapillary diverticula with recurrent billiary stone. We have studied to assess the clinical significance of coexsting PAD on recurrent commonbile duct stones and to establish the rational operative procedure in primary or recurrent common duct stones with coexisting PAD. Materials and Methods : Medical records of 583 consecutive patients(May. 2006 ~ June. 2009) who performed ERCP for biliary symptoms were reviewed. We comparative study retrospectively have done between patients with and without PAD on treatment. Results : Incidence of PAD was 26.7% on ERCP, and increased in the old aged patients. Incidence of biliary stone in PAD group was higher than that of non-PAD group(73.1% vs. 52.7%), and gall stone involving common duct was more prevalent in PAD group than non-PAD group. PAD group showed higher stone recurrence rate (23.6% vs. 5.3%) and earlier recurrence following conventional treatment, and needs more multiple treatments, compared with non -PAD group. Intradiverticular papillae(IDP) type showed higher stone recurrence, compared with juxtapapillary diverticula(JPD) type (27.1% vs. 13.2%) Conclusion : PAD would be one of important contributing factors for development and recurrence of common bile duct.
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