Girdwood A H, Marks I N, Hatfield A R, Bornman P C, Kottler R E
S Afr Med J. 1985 Dec 7;68(12):876-7.
The pancreatograms, as assessed by endoscopic retrograde cholangiopancreatography, of 51 patients with alcohol-induced calcific pancreatitis (AICP), were compared after division of the patients into three groups according to their insufficiency patterns. The first group, consisting of 18 patients, was labelled as having 'disproportionate steatorrhoea' characterized either by overt steatorrhoea and mild or no diabetes or by mild steatorrhoea and a normal glucose tolerance test result. The second group of 15 patients had severe diabetes associated with overt, mild or no steatorrhoea and constituted the 'insufficiency' group. The third group consisted of 18 patients with little or no pancreatic insufficiency. Twelve of the 18 patients with disproportionate steatorrhoea had a proximal complete or incomplete obstruction of their main pancreatic ducts, compared with 3 out of 15 in the insufficiency group and 4 out of 18 in the group with little or no pancreatic insufficiency. In this study an increased incidence of complete or incomplete obstruction (P less than 0,002) was found in the patients with disproportionate steatorrhoea compared with the other two groups. This suggests that obstruction to pancreatic flow may account for the dominant clinical presentation of steatorrhoea in some patients with AICP.
通过内镜逆行胰胆管造影术评估了51例酒精性钙化性胰腺炎（AICP）患者的胰管造影图，根据患者的功能不全模式将其分为三组后进行了比较。第一组由18例患者组成，被标记为患有“不成比例的脂肪泻”，其特征为明显的脂肪泻且轻度糖尿病或无糖尿病，或轻度脂肪泻且葡萄糖耐量试验结果正常。第二组15例患者患有严重糖尿病，伴有明显、轻度或无脂肪泻，构成“功能不全”组。第三组由18例几乎没有或没有胰腺功能不全的患者组成。18例不成比例脂肪泻患者中有12例主胰管近端完全或不完全梗阻，相比之下，功能不全组15例中有3例，几乎没有或没有胰腺功能不全组18例中有4例。在本研究中，发现不成比例脂肪泻患者中完全或不完全梗阻的发生率增加（P<0.002），与其他两组相比。这表明胰腺液流梗阻可能是一些AICP患者脂肪泻主要临床表现的原因。
