Lowes J R, Rode J, Lees W R, Russell R C, Cotton P B
Department of Gastroenterology, Middlesex Hospital, London, UK.
Br J Surg. 1988 Nov;75(11):1129-33. doi: 10.1002/bjs.1800751125.
Fifty-eight consecutive surgical pancreatic resections for chronic pancreatitis were examined. Eight cases were identified with obstructive pancreatopathy; all underwent pancreato-duodenectomy. Histological examination revealed that obstruction in three cases was due to duodenal wall cysts, and in two patients it was associated with pancreas divisum (the accessory papilla was obstructed by a neuroendocrine tumour in one case and by ectopic pancreatic tissue in the other). One case each was due to obstruction of an anomalous duct by vegetable matter, to segmental pancreatitis, and to an intraductal carcinoma. Obstructive pancreatitis has many causes and diligent pre-operative assessment is required as surgical resection may be beneficial. Special efforts should be made to identify ductal anomalies, duodenal cysts, ectopic pancreatic tissue, and small ampullary tumours of exocrine and endocrine origin in order to define the aetiology of pancreatitis.
对58例因慢性胰腺炎而连续接受胰腺手术切除的病例进行了检查。发现8例存在梗阻性胰腺炎；所有患者均接受了胰十二指肠切除术。组织学检查显示，3例梗阻是由于十二指肠壁囊肿，2例与胰腺分裂有关（1例副乳头被神经内分泌肿瘤阻塞，另1例被异位胰腺组织阻塞）。各有1例梗阻分别是由于蔬菜物质阻塞异常导管、节段性胰腺炎和导管内癌所致。梗阻性胰腺炎有多种病因，术前需进行仔细评估，因为手术切除可能有益。应特别努力识别导管异常、十二指肠囊肿、异位胰腺组织以及外分泌和内分泌起源的小壶腹肿瘤，以明确胰腺炎的病因。
