Hernández Garcés Héctor R, Lazo del Vallin Sacha, Moutary Issoufou
National Institute of Gastroenterology, Havana, Cuba.
JOP. 2004 Jan;5(1):25-31.
The presence, course and shape of the accessory pancreatic duct have not been previously studied in patients with chronic pancreatitis.
The accessory pancreatic duct exhibits several appearances on pancreatography. It was examined using dye-injection endoscopic retrograde cholangiopancreatography, and the duct course and shape were studied in patients having chronic pancreatitis and were compared to patients with normal pancreatogram.
A prospective comparative study was carried out.
One hundred and 57 consecutive patients (79 males and 78 females) who underwent endoscopic retrograde cholangiopancreatography for suspicion of pancreatobiliary disease.
Forty-eight patients were diagnosed as having chronic pancreatitis using endoscopic retrograde cholangiopancreatography (28 alcoholic, 4 metabolic, and 16 idiopathic) and 109 patients had a normal pancreatogram.
The insertion type of the accessory pancreatic duct to the main pancreatic duct was determined and the terminal portion of the accessory pancreatic duct was described in both groups.
In patients with chronic pancreatitis, the insertion of the accessory pancreatic duct of short type prevailed; 31 patients (64.6%), independently of the degree of intensity of chronic pancreatitis. However, in patients with a normal pancreatogram, the intermediate and long type prevailed, 46 (42.2%) and 41 (37.6%) patients, respectively. In patients with a normal pancreatogram Stick type termination occurred in 66 patients (60.0%), and in patients having chronic pancreatitis, the Cudgel type was present in 34 patients (70.8%) which was statistically significant.
The accessory pancreatic duct should be analyzed when we carry out the cholangiopancreatography because the patients with short type insertion have a higher risk of developing chronic pancreatitis.
既往尚未对慢性胰腺炎患者的副胰管的存在、走行及形态进行研究。
副胰管在胰管造影上有多种表现。本研究采用染料注射式内镜逆行胰胆管造影术对其进行检查，研究慢性胰腺炎患者的副胰管走行及形态，并与胰管造影正常的患者进行比较。
进行一项前瞻性对照研究。
157例因怀疑胰胆疾病而接受内镜逆行胰胆管造影术的连续患者（79例男性和78例女性）。
48例患者经内镜逆行胰胆管造影术诊断为慢性胰腺炎（28例酒精性、4例代谢性和16例特发性），109例患者胰管造影正常。
确定两组患者副胰管与主胰管的汇合类型，并描述副胰管的终末部分。
在慢性胰腺炎患者中，短型副胰管汇合占优势；31例患者（64.6%），与慢性胰腺炎的严重程度无关。然而，在胰管造影正常的患者中，中型和长型汇合占优势，分别为46例（42.2%）和41例（37.6%）。在胰管造影正常的患者中，66例（60.0%）出现棒状终末，而在慢性胰腺炎患者中，34例（70.8%）出现棍棒状终末，具有统计学意义。
在进行胰胆管造影时应分析副胰管，因为短型汇合的患者发生慢性胰腺炎的风险较高。
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