Abstract: Objective To investigate the relationship between the incidence of duodenal papilla diverticulum and biliary and pancreatic diseases, and the influence on ERCP. Methods A total of 1203 patients, including 475 females and 728 males, underwent abdominal CT from July 1, 2020 to October 1, 2020 in Guangzhou Zengcheng District People′s Hospital. Among them, 23 patients with choledocholithiasis, cholangitis or biliary pancreatitis underwent ERCP. We observed the incidence of duodenal papillary diverticulum, the incidence of duodenal papillary diverticulum in patients with cholangiopancreatic diseases, the incidence of cholangiopancreatic diseases in patients with duodenal papillary diverticulum, and the success rate of ERCP in patients with duodenal papillary diverticulum. And we analyzed the relationship between duodenal diverticulum and cholangiopancreatic diseases and its influence on ERCP. Results The incidence of duodenal diverticulum was higher in women, P<0.05. The incidence of duodenal diverticulum was higher in patients over 40 years old, P<0.05. The incidence of extrahepatic bile duct stones, bile duct dilatation and pancreatitis were higher in patients with duodenal diverticulum than in patients without duodenal diverticulum, P<0.05. And the detection rate of duodenal diverticulum was higher in patients with extrahepatic bile duct stones, cholangitis and pancreatitis, P<0.05. ERCP intubation in duodenal diverticulum was difficult and the success rate was relatively low （P<0.05）. Conclusion Duodenal diverticulum has certain relationship with extrahepatic bile duct stones, cholangitis, pancreatitis and other diseases; ERCP intubation in duodenal diverticulum is difficult and the success rate is relatively low. Paying attention to and understanding of juxtapapillary duodenal diverticulum, preoperative imaging evaluation and mastering ERCP related skills are often helpful to improve the success rate of intubation with juxtapapillary duodenal diverticulum.

Key words: duodenal diverticulum, ERCP, common bile duct, pancreas, disease, therapy

摘要： 目的 探讨十二指肠乳头憩室的发生率与胆胰疾病的关系以及对ERCP手术的影响 方法 回顾性分析广州市增城区人民医院2020年7月1日至2020年10月1日全院各科室包括门急诊、住院部曾经进行了腹部CT的所有患者,共1203人,女性475人,男性728人,其中,因胆总管结石胆管炎、或胆源性胰腺炎行ERCP手术的患者23例。观察十二指肠乳头憩室的发生率、伴有胆胰病变病例中十二指肠乳头憩室的发生率、伴有十二指肠乳头憩室病例中胆胰病变的发生率,伴有十二指肠乳头憩室ERCP的成功率,分析十二指肠憩室与胆胰疾病关系及对ERCP的影响。结果 女性的十二指肠憩发生率高（与男性比较,P<0.05）;40岁以上,伴有十二指肠憩室发生率较高（P<0.05）;有十二指肠憩室比无十二指肠憩室的,肝外胆管结石胆管扩张、胰腺炎出现情况高（P<0.05）;而且有肝外胆管结石胆管炎、胰腺炎的病例中十二指肠憩室的发现率出较高（P<0.05）;十二指肠憩室主要发生于降部;十二指肠憩室ERCP插管难度较高,成功率相对较低（P<0.05）。结论 十二指肠憩室与肝外胆管结石胆管炎、胰腺炎等病变有一定的关系;十二指肠憩室ERCP插管难度较高,成功率相对较低.重视并了解十二指肠乳头旁憩室、术前影像学的评估、掌握ERCP相关技巧往往有助于提高伴有十二指肠乳头旁憩室的插管成功率。

关键词: 十二指肠憩室, ERCP, 胆总管, 胰腺, 疾病, 治疗