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[胆囊内异位胰腺。胰腺罕见发育异常的诊断、治疗及病程]

[Heterotopic pancreas in the gallbladder. Diagnosis, therapy, and course of a rare developmental anomaly of the pancreas].

作者信息

Neupert G, Appel P, Braun S, Tonus C

机构信息

Chirurgische Klinik I, Klinikum Offenbach, Starkenburgring 66, 63069 Offenbach.

出版信息

Chirurg. 2007 Mar;78(3):261-4. doi: 10.1007/s00104-006-1203-6.

Abstract

Ectopic pancreas is a rare entity but the second most prevalent pancreatic anomaly. Heterotopic pancreas is defined as the presence of pancreatic tissue without any anatomic or vascular continuity with the main body of the pancreas. Its aetiology is not clearly established. In 1916, Poppi published for the first time evidence of heterotopic pancreas in the gallbladder. A review of the literature up to the present showed only 28 more cases worldwide of ectopic pancreas in the gallbladder. Aberrant pancreas is incidentally discovered in 2% of autopsies and has been estimated to occur once in every 500 upper abdominal explorations. Ninety per cent of ectopic pancreas is found in the stomach, duodenum, and jejunum. Mostly it is asymptomatic and benign. For this reason, therapy is indicated only in patients with symptoms such as pyloric obstruction, bleeding, and malignant transformation. Surgical resection or endoscopic mucosal resection as a newer method are recommended.

摘要

异位胰腺是一种罕见的实体,但却是第二常见的胰腺异常。异位胰腺被定义为存在与胰腺主体没有任何解剖或血管连续性的胰腺组织。其病因尚未明确确立。1916年,波皮首次发表了胆囊中存在异位胰腺的证据。对截至目前的文献回顾显示,全球范围内胆囊异位胰腺仅另有28例病例。异位胰腺在2%的尸检中偶然被发现,据估计每500次上腹部探查中会出现1次。90%的异位胰腺位于胃、十二指肠和空肠。大多数情况下它是无症状的且为良性。因此,仅在出现幽门梗阻、出血和恶性转化等症状的患者中才需要进行治疗。建议进行手术切除或采用更新的方法即内镜黏膜切除术。

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