Am J Gastroenterol. 2012 Feb;107(2):318-20. doi: 10.1038/ajg.2011.430.
Bertin et al. partially dispel arguments that pancreas divisum (PD) causes pancreatitis, but fascinatingly indicate that PD associates with CFTR gene mutations predisposing to pancreatitis. This association, however, does not definitely confer a pathophysiological role for PD in pancreatitis but may denote that PD co-mingles with CFTR mutations without influencing pancreatitis or CFTR mutations influence pancreatic duct embryogenesis. We advise "idiopathic pancreatitis" patients with PD to undergo genetic testing. In lieu of CFTR mutations undertake no endoscopic/surgical procedure; if CFTR mutations are found, then refer patients for genetic counseling and withhold endoscopic/surgical therapy unless randomized studies show benefit.
Bertin 等人部分驳斥了胰胆管合流异常(PD)导致胰腺炎的观点,但有趣的是指出 PD 与 CFTR 基因突变相关,使个体易患胰腺炎。然而,这种关联并不能确定 PD 在胰腺炎中的病理生理作用,但可能表明 PD 与 CFTR 基因突变共存而不影响胰腺炎,或者 CFTR 基因突变影响胰腺导管胚胎发生。我们建议 PD 相关“特发性胰腺炎”患者进行基因检测。如果没有发现 CFTR 基因突变,则无需进行内镜/手术治疗;如果发现 CFTR 基因突变,则应进行遗传咨询,并在随机研究显示获益之前,避免进行内镜/手术治疗。