Khuroo Naira Sultan, Khuroo Mohammad Sultan, Khuroo Mehnaaz Sultan
Digestive Diseases Centre, Dr. Khuroo's Medical Clinic, Sector 1, Sher-e-Kashmir Colony, Qamarwari, Srinagar, Kashmir, India.
JOP. 2010 Jan 8;11(1):18-24.
Tropical calcific pancreatitis is unique to developing countries with of unknown origin.
We evaluated the pattern of pancreaticobiliary ductal union in patients with tropical calcific pancreatitis.
Twenty-one patients with tropical calcific pancreatitis were compared to 174 control subjects with no pancreaticobiliary disease and 35 patients with alcohol-induced chronic pancreatitis.
Two experienced people, blinded to the results, evaluated the pattern of pancreaticobiliary ductal union. Pancreaticobiliary ductal unions were classified as: separate ducts (no union), a short common-channel (length less than 6 mm), a long common-channel (length ranging 6-15 mm) and anomalous pancreaticobiliary ductal union (length greater than 15 mm). Anomalous union was defined as P-B type when the pancreatic duct appeared to join the bile duct and B-P type when the bile duct appeared to join the pancreatic duct. Any disparities between the two investigators were sorted out by mutual discussion.
Pancreaticobiliary ductal union in tropical calcific pancreatitis patients as compared to those in the control group was as follows: separate ducts, 23.8% vs. 49.4% (P=0.036); a short common-channel, 4.8% vs. 28.7% (P=0.017); a long common channel, 33.3% vs. 18.4% (P=0.144) and anomalous pancreaticobiliary ductal union, 38.1% vs. 3.4% (P<0.001). The B-P pattern of anomalous pancreaticobiliary ductal union was more frequent in tropical calcific pancreatitis than in the control group but there was no statistical significance (P=0.103). The angle of the pancreaticobiliary ductal union in the tropical calcific pancreatitis group was 88.1 + or - 36.2 degrees as compared to 20.0 + or - 11.5 degrees in control group (P<0.001). Alcohol-induced chronic pancreatitis (No. 35) predominantly had either separate ducts (65.7%) or a short common channel (25.7%).
We concluded that patients with tropical calcific pancreatitis in Kashmir had anomalous pancreaticobiliary ductal union, predominantly of B-P type with a wide angle of ductal union more frequently. This may be related to the etiology of tropical calcific pancreatitis in such regions.
热带钙化性胰腺炎是发展中国家特有的疾病，病因不明。
我们评估了热带钙化性胰腺炎患者胰胆管联合的模式。
将21例热带钙化性胰腺炎患者与174例无胰胆管疾病的对照者以及35例酒精性慢性胰腺炎患者进行比较。
两名对结果不知情的经验丰富的人员评估胰胆管联合的模式。胰胆管联合分为：分离导管（无联合）、短共同通道（长度小于6mm）、长共同通道（长度在6 - 15mm之间）和异常胰胆管联合（长度大于15mm）。当胰管似乎汇入胆管时，异常联合定义为P - B型；当胆管似乎汇入胰管时，定义为B - P型。两位研究者之间的任何差异通过相互讨论解决。
热带钙化性胰腺炎患者的胰胆管联合与对照组相比情况如下：分离导管，23.8%对49.4%（P = 0.036）；短共同通道，4.8%对28.7%（P = 0.017）；长共同通道，33.3%对18.4%（P = 0.144）；异常胰胆管联合，38.1%对3.4%（P < 0.001）。热带钙化性胰腺炎中异常胰胆管联合的B - P模式比对照组更常见，但无统计学意义（P = 0.103）。热带钙化性胰腺炎组胰胆管联合的角度为88.1±36.2度，而对照组为20.0±11.5度（P < 0.001）。酒精性慢性胰腺炎（35例）主要为分离导管（65.7%）或短共同通道（25.7%）。
我们得出结论，克什米尔地区的热带钙化性胰腺炎患者存在异常胰胆管联合，主要为B - P型，且导管联合角度更宽更为常见。这可能与该地区热带钙化性胰腺炎的病因有关。
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