Nakagohri Toshio, Konishi Masaru, Inoue Kazuto, Takahashi Shinichiro, Tanizawa Yutaka, Kinoshita Taira
Department of Surgery, National Cancer Center Hospital East, Kashiwa, Japan.
Hepatogastroenterology. 2004 Sep-Oct;51(59):1504-5.
We report inferior head resection of the pancreas and cyst resection for congenital choledochal cyst with an anomalous arrangement of pancreaticobiliary duct and chronic calcifying pancreatitis. A 42-year-old man was admitted to the National Cancer Center Hospital East complaining of back pain. Contrast-enhanced computed tomography showed marked dilatation of the bile duct and multiple pancreatic stones in the main pancreatic duct. Endoscopic retrograde cholangiopancreatography demonstrated pancreatic stones in the dilated main pancreatic duct. The patient underwent cyst excision, inferior head resection of the pancreas, hepaticojejunostomy and lateral pancreaticojejunostomy. The postoperative course was uneventful. This procedure relieved the back pain. Choledochal cyst with anomalous arrangement of the pancreaticobiliary duct is frequently associated with acute pancreatitis. Inferior head resection of the pancreas removed the common channel which could be the cause of relapsing pancreatitis. Thus, inferior head resection can play a role in the management of choledochal cyst with chronic pancreatitis.
我们报告了针对先天性胆总管囊肿合并胰胆管异常排列及慢性钙化性胰腺炎行胰头下部切除术及囊肿切除术的病例。一名42岁男性因背痛入住国立癌症中心东医院。增强计算机断层扫描显示胆管明显扩张,主胰管内有多个胰石。内镜逆行胰胆管造影显示扩张的主胰管内有胰石。患者接受了囊肿切除、胰头下部切除、肝空肠吻合术及胰体尾空肠侧侧吻合术。术后病程顺利。该手术缓解了背痛。胰胆管异常排列的胆总管囊肿常与急性胰腺炎相关。胰头下部切除术切除了可能是复发性胰腺炎病因的共同通道。因此,胰头下部切除术在慢性胰腺炎合并胆总管囊肿的治疗中可发挥作用。