Neoptolemos J P, Davidson B R, Winder A F, Vallance D
Department of Surgery, Leicester Royal Infirmary, UK.
Br J Surg. 1988 May;75(5):450-3. doi: 10.1002/bjs.1800750517.
Duodenal bile crystal analysis for the detection of gallstones was assessed in 26 patients with acute pancreatitis of known aetiology (11 attributable to gallstones and 15 to alcohol) and in 37 patients without a history of acute pancreatitis (21 with gallstones and 16 without). The sensitivity was 64-67 per cent and the specificity was 94-100 per cent in these groups. Analysis of duodenal bile from 14 patients with 'idiopathic' pancreatitis revealed calcium bilirubinate crystals (but not cholesterol crystals) in 5 patients (36 per cent). Gallstones were confirmed at cholecystectomy in three of these patients and also in one other patient who had a gallstone on a 'late' ultrasound examination but was negative for crystals. Thus 29 per cent of the original 'idiopathic' group had gallstones confirmed. Gallstone analysis showed that pigment stones were present in 7 of 31 (23 per cent) non-pancreatitis controls compared with 9 of 13 (69 per cent) pancreatitis patients (P = 0.0048). These results suggest that duodenal bile crystal analysis (involving both calcium bilirubinate and cholesterol crystals) may be a useful technique for the investigation of patients with 'idiopathic' pancreatitis.
对26例已知病因的急性胰腺炎患者（11例由胆结石引起，15例由酒精引起）以及37例无急性胰腺炎病史的患者（21例有胆结石，16例无胆结石）进行十二指肠胆汁晶体分析以检测胆结石。这些组的敏感性为64% - 67%，特异性为94% - 100%。对14例“特发性”胰腺炎患者的十二指肠胆汁分析显示，5例患者（36%）有胆红素钙晶体（但无胆固醇晶体）。其中3例患者在胆囊切除术中证实有胆结石，另有1例患者在“晚期”超声检查时有胆结石但晶体检测为阴性。因此，最初的“特发性”组中有29%的患者被证实有胆结石。胆结石分析表明，31例非胰腺炎对照组中有7例（23%）存在色素结石，而13例胰腺炎患者中有9例（69%）存在色素结石（P = 0.0048）。这些结果表明，十二指肠胆汁晶体分析（包括胆红素钙晶体和胆固醇晶体）可能是用于调查“特发性”胰腺炎患者的一种有用技术。
