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儿童 Roux-en-Y 胆总管空肠吻合术后胆总管残端结石与复发性急性胰腺炎：一例报告

Common bile duct stump stones and recurrent acute pancreatitis after Roux-en-Y choledochojejunostomy in a child: A case report.

作者信息

Li Jian-Feng, Xie Min-Jian, Wei Jin-Xiu, Yang Cheng-Ning, Chen Guang-Wen, Li Li-Qun, Zhao Yi-Na, Liu Li-Jian, Xie Sheng

机构信息

Department of Gastroenterology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning 530023, Guangxi Zhuang Autonomous Region, China.

Faculty of Graduate Studies, Guangxi University of Chinese Medicine, Nanning 530222, Guangxi Zhuang Autonomous Region, China.

出版信息

World J Gastrointest Surg. 2025 Feb 27;17(2):102105. doi: 10.4240/wjgs.v17.i2.102105.

DOI:10.4240/wjgs.v17.i2.102105
PMID:40061985
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11885987/
Abstract

BACKGROUND

Pancreaticobiliary maljunction (PBM) is a rare congenital abnormality in pancreaticobiliary duct development. PBM is commonly found in children, and it often leads to acute pancreatitis and other diseases as a result of pancreaticobiliary reflux. Roux-en-Y choledochojejunostomy is a common surgical method for the treatment of PBM, but there are several associated complications that may occur after this operation.

CASE SUMMARY

The patient, a 12-year-old female, was hospitalized nearly 20 times in 2021 for recurrent acute pancreatitis. In 2022, she was diagnosed with PBM and underwent laparoscopic common bile duct resection and Roux-en-Y choledochojejunostomy in a tertiary hospital. In the first year after surgery, the patient had more than 10 recurrent acute pancreatitis episodes. After undergoing abdominal computed tomography and other examinations, she was diagnosed with "residual bile duct stones and recurrent acute pancreatitis". On January 30, 2024, the patient was admitted to our hospital due to recurrent upper abdominal pain and was cured through endoscopic retrograde cholangiopancreatography.

CONCLUSION

This article reports a case of a child with distal residual common bile duct stones and recurrent acute pancreatitis after Roux-en-Y choledochojejunostomy for PBM. The patient was cured through endoscopic retrograde cholangiopancreatography.

摘要

背景

胰胆管合流异常（PBM）是一种罕见的胰胆管发育先天性异常。PBM常见于儿童，常因胰胆管反流导致急性胰腺炎等疾病。Roux-en-Y胆总管空肠吻合术是治疗PBM的常用手术方法，但该手术后可能会出现几种相关并发症。

病例摘要

该患者为一名12岁女性，2021年因复发性急性胰腺炎住院近20次。2022年，她被诊断为PBM，并在一家三级医院接受了腹腔镜胆总管切除术和Roux-en-Y胆总管空肠吻合术。术后第一年，患者出现10余次复发性急性胰腺炎发作。在接受腹部计算机断层扫描等检查后，她被诊断为“残余胆管结石和复发性急性胰腺炎”。2024年1月30日，患者因反复上腹痛入住我院，通过内镜逆行胰胆管造影术治愈。

结论

本文报道了1例因PBM行Roux-en-Y胆总管空肠吻合术后出现远端残余胆总管结石和复发性急性胰腺炎的儿童病例。该患者通过内镜逆行胰胆管造影术治愈。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a9db/11885987/2920d678ab83/102105-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a9db/11885987/19c8b44e2847/102105-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a9db/11885987/48d1914272f2/102105-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a9db/11885987/2920d678ab83/102105-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a9db/11885987/19c8b44e2847/102105-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a9db/11885987/48d1914272f2/102105-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a9db/11885987/2920d678ab83/102105-g003.jpg

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