Kamisawa Terumi, Yoshiike Masami, Egawa Naoto, Tsuruta Kouji, Okamoto Atsutake, Funata Nobuaki
Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, 113-8677 Tokyo, Japan.
J Gastroenterol Hepatol. 2005 Jun;20(6):915-8. doi: 10.1111/j.1440-1746.2005.03774.x.
Although there has been considerable controversy regarding pancreas divisum and pancreatitis, little discussion of this has taken place. The purpose of the present paper was to investigate the relationship between these two conditions.
A retrospective investigation was undertaken of pancreatic tumors associated with pancreas divisum, in 650 cases of pancreatic carcinoma, 80 cases of intraductal papillary mucinous tumor of the pancreas and 32 cases of pancreas divisum.
Of these 32 cases, four (12.5%) were associated with pancreatic tumor: pancreatic carcinoma (n = 3) and intraductal papillary mucinous tumor (n = 1). All tumors developed from the dorsal pancreas of pancreas divisum. Periductal and interlobular fibrosis detected in the non-carcinomatous pancreas of the margin of distal pancreatectomy implied that chronic dorsal pancreatitis associated with pancreas divisum preceded carcinoma.
Pancreatic tumors were detected in 12.5% of cases of pancreas divisum. In pancreas divisum, longstanding pancreatic duct obstruction caused by relative stenosis of the minor duodenal papilla might be a factor promoting oncogenesis.
尽管关于胰腺分裂症与胰腺炎之间存在相当大的争议，但对此的讨论却很少。本文的目的是研究这两种情况之间的关系。
对650例胰腺癌、80例胰腺导管内乳头状黏液性肿瘤以及32例胰腺分裂症患者中与胰腺分裂症相关的胰腺肿瘤进行了回顾性调查。
在这32例患者中，4例（12.5%）与胰腺肿瘤相关：胰腺癌（3例）和导管内乳头状黏液性肿瘤（1例）。所有肿瘤均起源于胰腺分裂症的背侧胰腺。在远端胰腺切除边缘的非癌性胰腺中检测到的导管周围和小叶间纤维化表明，与胰腺分裂症相关的慢性背侧胰腺炎先于癌症发生。
在12.5%的胰腺分裂症病例中检测到胰腺肿瘤。在胰腺分裂症中，十二指肠小乳头相对狭窄导致的长期胰管梗阻可能是促进肿瘤发生的一个因素。
