急性胆源性胰腺炎中胰胆管交界处及胰管系统形态学。一项早期内镜逆行胰胆管造影术的前瞻性研究。

Pancreatico-choledochal junction and pancreatic duct system morphology in acute biliary pancreatitis. A prospective study with early ERCP.

作者信息

Uomo G, Rabitti P G, Laccetti M, Visconti M

机构信息

Pancreatic Disease Center, A. Cardarelli Hospital, Naples, Italy.

出版信息

Int J Pancreatol. 1993 Jun;13(3):187-91. doi: 10.1007/BF02924439.

DOI:10.1007/BF02924439

PMID:8370980

Abstract

Sixty-two patients with acute biliary pancreatitis (ABP) were prospectively studied by early ERCP in order to evaluate the morphology of the pancreatico-choledochal junction and the pancreatic duct system (PDS) and compared with 62 control patients. Abnormalities of the ampulla of Vater were observed in 66.1% (33.5% in controls; p = 0.001). A common channel for the common bile duct and the main pancreatic duct (MPD) were found in 70.9% of ABP cases; the length of common channel was < or = 5 mm in 79.5% and > 5 mm in 20.4%; the angle between CBD and MPD was < or = 30 degrees in 88.6% and > 30 degrees in 11.4% (no difference compared to the control group). A patent Santorini's duct were found in 37% of ABP cases vs 38.7% in controls (NS); there was no significant difference in patency of the duct of Santorini between edematous and necrotizing cases of ABP. Morphological changes of the PDS were found in all patients with necrotizing (22 cases) and in 15 out of 40 patients with edematous ABP (p < 0.0001).

摘要

为了评估胰胆管交界处和胰管系统（PDS）的形态，对62例急性胆源性胰腺炎（ABP）患者进行了早期内镜逆行胰胆管造影（ERCP）的前瞻性研究，并与62例对照患者进行比较。在66.1%的ABP患者中观察到 Vater壶腹异常（对照组为33.5%；p = 0.001）。在70.9%的ABP病例中发现胆总管和主胰管（MPD）存在共同通道；79.5%的共同通道长度≤5 mm，20.4%的共同通道长度＞5 mm；胆总管与MPD之间的夹角在88.6%的病例中≤30度，在11.4%的病例中＞30度（与对照组相比无差异）。37%的ABP病例中发现Santorini管通畅，而对照组为38.7%（无统计学差异）；ABP水肿型和坏死型病例的Santorini管通畅情况无显著差异。在所有坏死型患者（22例）以及40例水肿型ABP患者中的15例中发现了PDS的形态学改变（p < 0.0001）。