土耳其患者的胰胆管合流异常：一项多中心病例系列研究。

Pancreaticobiliary maljunction in Turkish patients: a multicenter case series.

机构信息

Department of Gastroenterology, Faculty of Medicine, Hacettepe University, 06100, Altindag, Ankara, Turkey.

Department of Gastroenterology, Faculty of Medicine, Sakarya University, 54040, Korucuk, Sakarya, Turkey.

出版信息

Surg Endosc. 2022 Mar;36(3):2042-2051. doi: 10.1007/s00464-021-08490-2. Epub 2021 Apr 12.

DOI:10.1007/s00464-021-08490-2

PMID:33844087

Abstract

BACKGROUND AND AIMS

Pancreaticobiliary maljunction (PBM) is a malformation in which the pancreatic and bile ducts join outside the duodenal wall. It is associated with various biliary and pancreatic diseases. In addition, patients with PBM carry a substantial lifetime risk of developing biliary or gallbladder carcinoma. We aimed to present a multicenter case series of PBM from Turkey.

METHODS

This study was conducted in adult and pediatric PBM patients who were referred to three tertiary reference centers of Turkey for endoscopic retrograde cholangiopancreatography (ERCP) between July 2007 and May 2020. The clinical presentations, types of PBM, ERCP findings, surgical histories, and the postoperative courses, including the development of biliary malignancies, were retrospectively reviewed.

RESULTS

The study group included 47 (31 adult and 16 children) patients. Type D PBM was more frequent (13/41: 27.7%) than that reported in Eastern studies. Type A PBM was more common in the adults (51.6% vs. 12.5%, p < 0.05), whereas type C was more common in pediatric patients (31.3% vs. 13.2%, p < 0.05). Although fusiform anatomy was predominant in both of the groups, cystic dilatation was more common (25.8% vs. 12.5%) in adults and the common bile duct diameter was greater [22 mm (range 11-58) vs. 12 mm (range 5-33)] in adult patients compared to pediatric patients. Resective surgeries were more frequently done in pediatric patients (73.3% vs. 53.6%), whereas cholecystectomy was more frequently performed in adult patients (21.4% vs. 6.7%).

CONCLUSION

Although our findings were compatible with Eastern studies, type D PBM (associated with pancreas divisum) was more frequent in our study population.

摘要

背景和目的

胰胆管合流异常（PBM）是一种胰管和胆管在十二指肠壁外汇合的畸形。它与各种肝胆胰疾病有关。此外，PBM 患者终生患胆管或胆囊癌的风险很大。我们旨在展示来自土耳其的多中心 PBM 病例系列。

方法

本研究纳入了 2007 年 7 月至 2020 年 5 月期间因内镜逆行胰胆管造影（ERCP）而被转诊至土耳其三个三级参考中心的成人和儿科 PBM 患者。回顾性分析了这些患者的临床表现、PBM 类型、ERCP 结果、手术史以及包括胆管恶性肿瘤发展在内的术后病程。

结果

研究组包括 47 名（31 名成人和 16 名儿童）患者。D 型 PBM 比东方研究报告的更常见（13/41：27.7%）。成人中 A 型 PBM 更为常见（51.6%比 12.5%，p<0.05），而儿童中 C 型更为常见（31.3%比 13.2%，p<0.05）。尽管两组均以梭形解剖为主，但成人中囊性扩张更为常见（25.8%比 12.5%），且成人的胆总管直径较大[22mm（范围 11-58）比 12mm（范围 5-33）]。与儿科患者相比，切除性手术更常应用于儿科患者（73.3%比 53.6%），而胆囊切除术更常应用于成人患者（21.4%比 6.7%）。