Angelini G, Sgarbi D, Castagnini A, Cavallini G, Bovo P
Istituto di Medicina Interna, Università di Verona, Italy.
Ital J Gastroenterol. 1994 Mar;26(2):79-82.
The features of the common bile duct (CBD) have been checked in 78 chronic pancreatitis patients in order to evaluate the frequency of extrahepatic bile duct changes, possible associated factors and effects on the outcome of the disease. Fifty of the 78 patients had an intrapancreatic stricture of the CBD and 24 of them also showed an upstream dilatation. No relationship was found between the features of the CBD and the severity of the pancreatitis, the presence of calcifications and the length of the disease. Humoral signs of impaired bile flow were found in 20 subjects, 19 of whom had an intra-pancreatic stricture of the CBD. Sixteen of these 19 patients also showed an upstream dilatation and five of them had overt jaundice. A surgical intervention on the biliary tree was carried out in 7 patients, all with a biliary stricture. Six of them also had a CBD dilatation over the stricture (p < 0.02 versus patients without CBD stricture). In conclusion CBD involvement during chronic pancreatitis is quite frequent but poorly predictable and should be checked in all patients with humoral cholestasis in order to prevent further complications.
为了评估肝外胆管改变的频率、可能的相关因素以及对疾病预后的影响，我们对78例慢性胰腺炎患者的胆总管（CBD）特征进行了检查。78例患者中有50例存在胆总管胰腺内段狭窄，其中24例还表现为上游扩张。未发现胆总管特征与胰腺炎严重程度、钙化的存在以及病程长短之间存在关联。在20名受试者中发现了胆汁流动受损的体液学迹象，其中19例存在胆总管胰腺内段狭窄。这19例患者中有16例也表现为上游扩张，5例出现明显黄疸。7例患者对胆道进行了手术干预，均存在胆道狭窄。其中6例在狭窄上方也有胆总管扩张（与无胆总管狭窄的患者相比，p < 0.02）。总之，慢性胰腺炎期间胆总管受累相当常见，但难以预测，对于所有有体液性胆汁淤积的患者都应进行检查，以预防进一步的并发症。
