Department of Pediatric Surgery, Hirosaki University School of Medicine, 53 Honcho, Hirosaki, Aomori, Japan.
J Hepatobiliary Pancreat Sci. 2010 May;17(3):345-8. doi: 10.1007/s00534-009-0252-x. Epub 2010 Feb 17.
Sonographic demonstration of extramural and intrapancreatic junction of the pancreatic and bile ducts, pathognomonic for pancreatico-biliary maljunction (PBM), is not easy in pediatric patients. We measured sonographic thickness of the gallbladder (GB) and retrospectively examined correlation of it with PBM.
Twenty-seven children with PBM were examined with conventional ultrasonography (US). All patients underwent hepaticojejunostomy, and resected GB were studied in histological examination. Preoperative extracorporeal US measured gallbladder wall thickness, and abnormal GB wall was defined 3 mm or more in thickness.
They consisted of 8 males and 19 females, ranging in age from 2 months to 11 years. The thickness of the GB wall was more than 3 mm in 18: 10 with smooth thickness and 8 with non-uniform thickness. The thickness of GB wall was found in 16 (84.2%) of the 19 patients more than 1 year of age. The difference between sonographic and macroscopic measurements of the wall thickness was less than 1 mm in 24 (89%) of the 27 patients.
US measurement of gallbladder wall thickness can be a screening test more than 1 year of age for PBM.
在儿科患者中，超声显示胰胆管外膜和胰内交界处，即胰胆管汇合异常（PBM）的特征性表现并不容易。我们测量了胆囊（GB）的超声厚度，并回顾性检查了其与 PBM 的相关性。
对 27 例 PBM 患儿进行常规超声检查。所有患者均行胆肠吻合术，并对切除的胆囊进行组织学检查。术前体外超声测量胆囊壁厚度，异常胆囊壁定义为厚度≥3mm。
患儿中男 8 例，女 19 例，年龄 2 个月至 11 岁。18 例胆囊壁厚度>3mm：10 例厚度均匀，8 例厚度不均匀。19 例>1 岁的患儿中，16 例（84.2%）GB 壁厚度>3mm。27 例患者中，24 例（89%）超声与大体测量的壁厚度差值<1mm。
对于>1 岁的患儿，超声测量胆囊壁厚度可作为 PBM 的筛查试验。
