Li Jian-Shui, Zhang Zhao-Da, Tang Yong, Jiang Rong
Department of General Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
Hepatobiliary Pancreat Dis Int. 2007 Apr;6(2):208-12.
Pancreatic duct stone is a rare disease, but there appears to be a rising trend in its incidence in recent years. Its pathogenesis remains unknown. The causes, diagnosis and treatment of pancreatic duct stone are reviewed through a retrospective analysis of the cases treated in our hospital.
The medical records of 88 patients with pancreatic duct stone treated in West China Hospital, Sichuan University from January 1, 1998 to November 30, 2004 were analyzed retrospectively in terms of clinical characteristics, diagnosis and treatment.
Epigastric pain was the most common symptom in the 88 patients with an average age of 45.44+/-6.72 years. Various other symptoms were also observed. Eighty-one patients were subjected to B-ultrasonography, 51 to CT, and 47 to magnetic resonance cholangiopancreatography (MRCP). Fifty-six patients (63.64%) were operated on, 25 (28.41%) were treated with Chinese and Western medicine, and 7 (7.95%) abandoned treatment. Chronic pancreatitis was pathologically confirmed in all patients undergoing operation.
B-ultrasonography is the first choice to check for pancreatic duct stone, while MRCP proves instructively useful for the diagnosis and treatment. Chronic pancreatitis is the most important cause of pancreatic duct stone, but whether there is not a direct correlation between stone formation and alcohol abuse needs further study in China. Surgery is the most curative method for pancreatic duct stone patients with severe symptoms or suspected pancreatic carcinoma, while individual treatment is emphasized, and microtraumatic surgery may be a developing option for treating pancreatic stone.
胰管结石是一种罕见疾病，但近年来其发病率似乎呈上升趋势。其发病机制尚不清楚。通过对我院治疗病例的回顾性分析，对胰管结石的病因、诊断及治疗进行综述。
回顾性分析1998年1月1日至2004年11月30日在四川大学华西医院接受治疗的88例胰管结石患者的病历，分析其临床特征、诊断及治疗情况。
88例患者中，上腹部疼痛是最常见症状，平均年龄为45.44±6.72岁。还观察到其他各种症状。81例患者接受了B超检查，51例接受了CT检查，47例接受了磁共振胰胆管造影（MRCP）检查。56例患者（63.64%）接受了手术治疗，25例（28.41%）接受了中西医结合治疗，7例（7.95%）放弃治疗。所有接受手术的患者经病理证实均患有慢性胰腺炎。
B超是检查胰管结石的首选方法，而MRCP对诊断和治疗具有指导意义。慢性胰腺炎是胰管结石最重要的病因，但在中国结石形成与酒精滥用之间是否没有直接关联尚需进一步研究。对于症状严重或疑似胰腺癌的胰管结石患者，手术是最有效的治疗方法，同时强调个体化治疗方法，微创外科手术可能是治疗胰腺结石的一个发展方向。
