Hiramatsu Takeshi, Itoh Akihiro, Kawashima Hiroki, Ohno Eizaburo, Itoh Yuya, Sugimoto Hiroyuki, Sumi Hajime, Funasaka Kohei, Nakamura Masanao, Miyahara Ryoji, Katano Yoshiaki, Ishigami Masatoshi, Ohmiya Naoki, Kaneko Kenitiro, Ando Hisami, Goto Hidemi, Hirooka Yoshiki
Department of Gastroenterology and Hepatology Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Endoscopy, Nagoya University Hospital, Nagoya, Japan.
J Pediatr Surg. 2015 Mar;50(3):377-81. doi: 10.1016/j.jpedsurg.2014.08.024. Epub 2014 Sep 18.
To assess the diagnostic ability and safety of endoscopic retrograde cholangiopancreatography (ERCP) in in-depth preoperative examination of children patients with pancreaticobiliary maljunction (PBM).
In 63 patients with a definite diagnosis of PBM, the ability to visualize the bile and main pancreatic ducts was compared between ERCP, which was performed in 63 patients with a definite diagnosis of PBM, and magnetic resonance cholangiopancreatography (MRCP), which was performed before ERCP in 29 patients. For ERCP, its complications were also evaluated.
The intrahepatic bile ducts could be visualized using ERCP in 44 patients (69.8%) and using MRCP in 18 (62.1%). The extrahepatic bile ducts could be visualized using ERCP in 59 patients (93.7%) and using MRCP in 29 (100%). The rates of the visualization of the main pancreatic duct and pancreaticobiliary ductal union were significantly higher in using ERCP than in using MRCP (96.8 vs. 41.4% and 90.5 vs. 37.9%, respectively; P<0.0001). As complications, hyperamylasemia developed in 12 patients (19%), but no other severe complications such as pancreatitis were observed.
ERCP as part of an in-depth preoperative examination of children with PBM is useful and safe.
评估内镜逆行胰胆管造影术（ERCP）对胰胆管合流异常（PBM）患儿进行术前深入检查的诊断能力及安全性。
对63例确诊为PBM的患者，比较63例确诊为PBM患者接受的ERCP与29例在ERCP前接受磁共振胰胆管造影（MRCP）检查时显示肝内外胆管及主胰管的能力。同时评估ERCP的并发症。
44例（69.8%）患者的肝内胆管通过ERCP显影，18例（62.1%）通过MRCP显影。59例（93.7%）患者的肝外胆管通过ERCP显影，29例（100%）通过MRCP显影。ERCP显示主胰管及胰胆管汇合处的比例显著高于MRCP（分别为96.8%对41.4%和90.5%对37.9%；P<0.0001）。并发症方面，12例患者（19%）出现高淀粉酶血症，但未观察到胰腺炎等其他严重并发症。
ERCP作为PBM患儿术前深入检查的一部分是有用且安全的。
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