Riemann J F, Lux G
Fortschr Med. 1984 Feb 23;102(8):179-82.
Ampullary obstruction due to bile duct stones with consecutive bilio-pancreatic reflux probably plays a major role in the pathogenesis of acute biliary pancreatitis. Because of this presumable pathogenesis endoscopic papillotomy in several clinical studies has proven to be effective. At the Department of Medicine, University of Erlangen-Nürnberg, since 1979 27 patients with suspicion of biliary pancreatitis have been examined by means of ERCP. In 15 patients common bile duct stones could be verified; these patients underwent endoscopic papillotomy. Their clinical course could be influenced favorably. The remaining patients had a temporary bile duct obstruction. Spontaneous stone passage apparently led to a quick reduction of clinical symptoms. The problem of endoscopic papillotomy in biliary pancreatitis is discussed using a patient with gallbladder stones but failure to verify common bile duct stones.
胆管结石导致壶腹梗阻并伴有连续性胆胰反流，这可能在急性胆源性胰腺炎的发病机制中起主要作用。基于这种可能的发病机制，内镜下乳头切开术在多项临床研究中已被证明是有效的。自1979年以来，在埃尔朗根 - 纽伦堡大学医学部，对27例疑似胆源性胰腺炎的患者进行了内镜逆行胰胆管造影（ERCP）检查。在15例患者中证实存在胆总管结石；这些患者接受了内镜下乳头切开术。他们的临床病程得到了有利的改善。其余患者存在暂时性胆管梗阻。结石自行排出显然导致临床症状迅速减轻。通过一名患有胆囊结石但未证实胆总管结石的患者，对胆源性胰腺炎内镜下乳头切开术的问题进行了讨论。
