Lowes J R, Lees W R, Cotton P B
Gastroenterology Unit, Middlesex Hospital, London, England.
Pancreas. 1989;4(3):371-4. doi: 10.1097/00006676-198906000-00015.
Pancreas divisum is the most common anatomical variant of pancreatic ductal anatomy. It has been suggested that obstruction at the accessory papilla in subjects with pancreas divisum can be assessed by measurement of ductal diameter by ultrasonic examination after a maximal secretory stimulus with i.v. secretin. We have prospectively assessed this test in 44 individuals; nine healthy controls, nine patients with abdominal pain and normal pancreatic anatomy, 17 patients with pancreas divisum and abdominal pain but no other evidence of pancreatitis, and nine patients with pancreas divisum and either chronic or recurrent acute pancreatitis. We have found no correlation between ductal anatomy and response to i.v. secretin. Secretin provocation tests do not indicate which patients have accessory papillary stenosis and do not add support to the hypothesis of obstruction leading to pancreatitis in patients with pancreas divisum.
胰腺分裂是胰腺导管解剖结构中最常见的解剖变异。有人提出，对于胰腺分裂的患者，在静脉注射促胰液素进行最大分泌刺激后，通过超声检查测量导管直径，可以评估副乳头处的梗阻情况。我们对44名个体进行了前瞻性评估，其中包括9名健康对照者、9名腹痛且胰腺解剖结构正常的患者、17名胰腺分裂且腹痛但无其他胰腺炎证据的患者以及9名胰腺分裂且患有慢性或复发性急性胰腺炎的患者。我们发现导管解剖结构与静脉注射促胰液素后的反应之间没有相关性。促胰液素激发试验无法表明哪些患者存在副乳头狭窄，也不能支持胰腺分裂患者中梗阻导致胰腺炎这一假说。
