Clinical Gastroenterology Vol.15 No.9(3)

Theme Digestive Diseases to Know --Duodenum
Title Lemmel's Syndrome
Publish Date 2000/08
Author Tsukasa Aihara Department of Surgery 1, National Defense Maedical Colledge
Author Kazuo Hatsuse Department of Surgery 1, National Defense Maedical Colledge
[ Summary ] We sometimes see patients with duodenal diverticula who have no usual symptoms. However, juxtapapillary duodenal diverticula (JPD) often accompany hepatocholangiopancreatic diseases, because of their anatomical proximity to the papillae Vateri. We categorize these cases as Lemmel's syndrome, when they include symptoms due to JPD, without symptoms of hepatocholangiopancreatic diseases, such as cholangiolithiasis, cholecystitis etc. Patients with JPD are likely to have dysfunctional sphincters of Oddi and suffer from regurgitation of their duodenal contents with intestinal bacteria, into the bile duct and the pancreatic duct, therefore hepatocholangiopancreatic disorders may occur.
Recently the use of laparoscopic surgery and endoscopic intervention techniques for treatment of cholangiolithiasis has increased. Long term observation after such treatments are need for treatment of hepatocholangiopancreatic diseases associated with JPD. Moreover, methods for evaluating JPD effects on hepatocholangiopancreatic disorders should be established.
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