Hiramatsu Kiyoshi, Ito Takaaki, Kaburagi Daisuke, Arai Riki, Maruyama Hideki, Naganuma Atsushi, Kato Kenji
Department of Surgery, Kiryu Kosei General Hospital, Japan.
Nihon Shokakibyo Gakkai Zasshi. 2008 Sep;105(9):1390-5.
A 52-year-old-man was admitted to our hospital for obstructive jaundice. Percutaneous transhepatic cholangio drainage (PTCD) and endscopic retrograde cholangiopancreatography (ERCP) were performed, and pointed out stenosis of lower common bile duct (CBD) and pancreatobiliary maljunction. Brushing cytology of this lesion was negative for malignancy. CT and MRI revealed chronic inflammatory change in groove lesion with no mass formation suggesting tumor. So we diagnosed groove pancreatitis (segmental form) associated with pancreatobiliary maljunction, and operation (resection of the bile duct and biliary reconstruction by Roux-en-Y) was done. Resected specimen was revealed stenosis of the bile duct formed by fibrous tissue with no malignancy compatible to groove pancreatitis pathologically. This is first reported case of groove pancreatits associated with pancreatobiliary maljunction.
一名52岁男性因梗阻性黄疸入院。进行了经皮经肝胆道引流术(PTCD)和内镜逆行胰胆管造影术(ERCP),结果显示胆总管下段(CBD)狭窄及胰胆管合流异常。该病变的刷片细胞学检查未发现恶性肿瘤细胞。CT和MRI显示沟部病变有慢性炎症改变,无提示肿瘤的肿块形成。因此,我们诊断为与胰胆管合流异常相关的沟部胰腺炎(节段型),并实施了手术(胆管切除及Roux-en-Y胆管重建)。切除标本病理显示由纤维组织形成的胆管狭窄,无符合沟部胰腺炎的恶性病变。这是首例报道的与胰胆管合流异常相关的沟部胰腺炎病例。