Sudakov S K
Biull Eksp Biol Med. 1980 Jun;89(6):662-4.
Recently the so-called anomalous arrangement of the pancreatico-biliary duct has often been found in congenital choledochal cyst. This anomaly was also observed in all of our 11 cases in which cholangiograms demonstrated the lower portion of the common bile duct. Therefore, this anomaly has been thought to be responsible for the formation of choledochal cyst, we made a model of the anomalous arrangement of the pancreatico-biliary duct in 6 puppies by pancreatico-cholecystostomy. Cystic or spindle-shaped dilatation of the common bile duct was found in all 6 animals. It was proved that digestive effects of proteolytic enzymes in refluxed pancreatic juice on the wall of the biliary duct caused chemical inflammation, which made the strtuctural weakness of the common bile duct and stenosis at its lower portion. Destruction of elastic fibers was principal for the weakness of biliary duct. The wall of biliary duct is likely to be affected by activated pancreatic juice more severely than that of pancreatic duct. Anomalous arrangement of the pancreatico-biliary duct is a most important factor for etiology of congenital choledochal cyst.
最近，在先天性胆总管囊肿中常发现所谓的胰胆管异常排列。在我们所有11例经胆管造影显示胆总管下段的病例中也观察到了这种异常。因此，这种异常被认为是胆总管囊肿形成的原因，我们通过胰胆囊吻合术在6只幼犬中制作了胰胆管异常排列的模型。在所有6只动物中均发现胆总管呈囊性或纺锤形扩张。结果证明，反流胰液中的蛋白水解酶对胆管壁的消化作用引起化学性炎症，导致胆总管结构薄弱及其下段狭窄。弹性纤维的破坏是胆管薄弱的主要原因。胆管壁比胰管壁更容易受到活化胰液的影响。胰胆管异常排列是先天性胆总管囊肿病因的一个最重要因素。
