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胰管和胆管内的基础压力:50例标准化十二指肠镜经乳头压力测量结果(作者译)

[Basic pressure in the pancreatic duct and in the bile duct: results from 50 standardized duodenoscopic transpapillary pressure measurements (author's transl)].

作者信息

Weiss H D, Kramann B, Wuttke V, Anacker H

出版信息

Med Klin. 1977 Mar 25;72(12):519-23.

PMID:840126
Abstract

In 90 patients pressure measurements in the pancreatic duct (50 cases) and in the common bile duct (20 cases) were performed endoscopically. In the normal pancreas an averaged basis pressure in Wirsung's duct of 22.2 cm H2O was found with a range of 9.6 to 37.0 cm H2O. In two cases of marked chronic pancreatitis and in one case of pancreatic carcinoma the secretion pressure was considerably diminished. The mean basic pressure of the common bile duct amounted to 12.0 cm H2O with a range of 7.3 to 17.0 cm H2O. The pressure values in the duodenum were found to be considerably lower than in the pancreatic duct and the bile duct; they amounted to 5.3 cm H20 with a range of 0.6 to 10.9 cm H20. In both ducts two different patterns of ondulations were found: tracings of slight ondulations, i.e. slow pressure changes with a constant average pressure and tracings of coarse ondulations with quick increase and drop in pressure. It will be discussed, how these findings can be related to physiology and pathophysiology of the pancreatic and biliary duct system. The clinical relevance for detection of excretory insufficiency of the pancreas and of pathologic changes leading to stenosis of the duct system are considered.

摘要

对90例患者进行了内镜下胰管(50例)和胆总管(20例)压力测量。在正常胰腺中,发现主导管平均基础压力为22.2cmH₂O,范围为9.6至37.0cmH₂O。在2例重度慢性胰腺炎和1例胰腺癌患者中,分泌压力显著降低。胆总管平均基础压力为12.0cmH₂O,范围为7.3至17.0cmH₂O。发现十二指肠内压力值显著低于胰管和胆管,为5.3cmH₂O,范围为0.6至10.9cmH₂O。在两个导管中均发现了两种不同的波动模式:轻微波动的描记图,即压力缓慢变化且平均压力恒定;以及粗大波动的描记图,压力快速上升和下降。将讨论这些发现如何与胰胆管系统的生理和病理生理相关。还考虑了检测胰腺排泄功能不全以及导致导管系统狭窄的病理变化的临床意义。

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