Ảnh hưởng của túi thừa quanh bóng Vater tới đặc điểm lâm sàng và cận lâm sàng của bệnh nhân sỏi đường mật

Abstract

Objective: Periampullary diverticulum (PAD) is a common anatomical variation in the gastrointestinal tract, noted for its potential effect on biliary stone diseases. This study aims to evaluate the impact of PAD on the clinical and paraclinical characteristics of patients with biliary stones at the time of hospital admission. Subject and method: A retrospective descriptive study was conducted on 785 patients diagnosed with biliary stones who underwent endoscopic retrograde cholangiopancreatography at the 108 Military Central Hospital from January 2021 to December 2022. Patients were divided into two groups: Those with PAD (PAD, n = 180) and those without PAD (NPAD, n = 605). Clinical and paraclinical data were collected from medical records and analyzed. Result: The incidence of PAD in the study was 22.9%, with an increasing detection rate of PAD with age, especially in patients over 60 years old (82.8%). PAD did not affect primary clinical symptoms (abdominal pain, fever, jaundice) compared to NPAD. However, the incidence of severe cholangitis was significantly higher in the PAD group (25% vs. 17.3%, p=0.03), and sepsis was also more common (15.6% vs. 8.9%, p=0.02). The detection rate of intrahepatic biliary stones and combined common bile duct-liver stones was lower in the PAD group compared to NPAD. Conclusion: PAD does not alter clinical symptoms but is associated with an increased severity of cholangitis and infectious complications. Further studies are needed to clarify the role of PAD in the pathogenesis of biliary stones.