Müller H, Greiner P, Salm R, Wenz W, Fiedler L
Universitäts-Kinderklinik, Freiburg i. Br.
Monatsschr Kinderheilkd. 1988 Sep;136(9):640-3.
Anomalies of the pancreatico-biliary tract present the most frequent cause of posthepatic cholestasis in the young child, whereas calculous disease or infections or compression by vascular abnormalities or neoplasms are less frequent. Generally, abdominal pain and jaundice begin acutely and increase following progressive biliary congestion. The preoperative diagnosis by ERCP or PTC or the intraoperative diagnosis of a relevant pancreaticobiliary anomaly stress the necessity of an operative management performing a bypass of the Sphincter Oddi and of the site of the anomaly. Local operative revision alone seems to be associated with a frequent relapse of cholestasis.
胰胆管异常是幼儿肝后性胆汁淤积最常见的原因,而结石病、感染、血管异常或肿瘤压迫则较为少见。一般来说,腹痛和黄疸急性起病,并随着胆汁进行性淤积而加重。通过内镜逆行胰胆管造影(ERCP)或经皮肝穿刺胆管造影(PTC)进行术前诊断,或术中诊断相关的胰胆管异常,强调了进行手术治疗以绕过Oddi括约肌和异常部位的必要性。仅进行局部手术矫正似乎与胆汁淤积的频繁复发有关。