Katon R M, Bilbao M K, Eidemiller L R, Benson J A
Surg Gynecol Obstet. 1978 Sep;147(3):333-8.
Twenty-eight consecutive patients with idiopathic pancreatitis were studied. Endoscopic retrograde cholangiopancreatography was diagnostic in 21 of 28, while an operation was diagnostic in four of the remaining seven patients. Fifteen of 25 patients had operable disease of the gallbladder, common bile duct, ampulla of Vater or pancreatic duct. Of ten patients who had an operation on the pancreas or biliary tract, or both, for painful attacks of pancreatitis, none had a recurrence in a seven month to three year follow-up study. Two patients had reconstruction of the pancreatic duct for chronic painless steatorrhea, one of whom had marked clinical improvement. Ten of 25 patients had normal biliary tracts with normal or minimally abnormal pancreatic ducts and were treated medically. Visualization of biliary and pancreatic ducts should be attempted by endoscopic retrograde cholangiopancreatography in patients with pancreatitis of unknown cause. Operable lesions were found in 15 of 25 patients, and the postoperative results were excellent.
对28例连续性特发性胰腺炎患者进行了研究。内镜逆行胰胆管造影术对28例中的21例具有诊断价值，而手术对其余7例中的4例具有诊断价值。25例患者中有15例患有胆囊、胆总管、十二指肠乳头或胰管的可手术疾病。在因胰腺炎疼痛发作而对胰腺或胆道或两者进行手术的10例患者中，在为期7个月至3年的随访研究中均无复发。2例患者因慢性无痛性脂肪泻而行胰管重建术，其中1例临床症状明显改善。25例患者中有10例胆道正常，胰管正常或轻度异常，接受药物治疗。对于病因不明的胰腺炎患者，应尝试通过内镜逆行胰胆管造影术来观察胆管和胰管。25例患者中有15例发现了可手术病变，术后效果良好。
