急性胆源性胰腺炎的发病机制：一个有争议的问题。第一部分。胆胰反流的概念。

The pathogenesis of acute biliary pancreatitis: a controversial issue. Part I. The concept of biliopancreatic reflux.

作者信息

Arendt T

机构信息

Institute of Pathologic Anatomy, Wilhelm-Pieck-University, Rostock, DDR.

出版信息

Gastroenterol J. 1989;49(2):50-3.

PMID:2679658

Abstract

The pathophysiologic mechanism by which gallstone migration through the sphincter of Oddi may produce acute pancreatitis is a controversial issue. According to one concept, biliopancreatic reflux following concrement obstruction of the common biliopancreatic channel results in contact of bile with pancreatic parenchyma which is known to produce acute pancreatitis. However, the entrance of bile into pancreatic tissue is usually prevented by the pancreatic duct sphincter, by the pancreatic exocrine secretion pressure and by the pancreatic duct mucosal barrier. A breakdown of these protective mechanisms is an essential prerequisite for the validity of this concept. Relevant clinical and experimental data concerning this possibility are reviewed.

摘要

胆结石通过Oddi括约肌迁移导致急性胰腺炎的病理生理机制是一个有争议的问题。根据一种观点，胆胰共同通道结石梗阻后胆胰反流导致胆汁与胰腺实质接触，已知这会引发急性胰腺炎。然而，胆汁进入胰腺组织通常受到胰管括约肌、胰腺外分泌压力和胰管黏膜屏障的阻止。这些保护机制的破坏是这一观点成立的必要前提。本文回顾了有关这种可能性的相关临床和实验数据。