Suda K, Miyano T
Arch Pathol Lab Med. 1985 May;109(5):433-6.
Bile pancreatitis was studied both macropathologically and histopathologically in cases with an abnormal pancreatic choledochoductal junction, in which free communication between the pancreatic duct and the common bile duct occurred. The intraductal pressure of the pancreatic duct is normally higher than that of the bile duct, therefore, the pancreatic juice flows into the bile duct. In this study, we found squamous carcinoma cells from an adeno-squamous cell carcinoma of the gall-bladder in the main pancreatic duct. Hence, the possibility of bile reflux into the pancreatic duct was also considered. Outstanding findings, such as degeneration and disappearance of the pancreatic ductal epithelium, intraluminal aggregation of bacilli, and diffuse interlobular fibrosis were found in four of 15 cases with an abnormal junction. Similar ductal alterations and diffuse fibrosis were found neither in the controls nor in the remaining 11 cases. Therefore, it appears that pancreatic disorders due to the reflux of bile occurs in the presence of bacteria.
在胰胆管交界处异常、胰管与胆总管之间存在自由交通的病例中，对胆汁性胰腺炎进行了大体病理和组织病理学研究。正常情况下，胰管内压力高于胆管，因此胰液流入胆管。在本研究中，我们在主胰管中发现了来自胆囊腺鳞癌的鳞状癌细胞。因此，也考虑了胆汁反流至胰管的可能性。在15例交界处异常的病例中，有4例发现了显著的表现，如胰管上皮的变性和消失、管腔内杆菌聚集以及弥漫性小叶间纤维化。在对照组和其余11例病例中均未发现类似的导管改变和弥漫性纤维化。因此，似乎胆汁反流引起的胰腺疾病是在有细菌存在的情况下发生的。
