Maejima S, Kawa S, Hasebe O, Homma T
Second Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Pancreas. 1996 Aug;13(2):209-14. doi: 10.1097/00006676-199608000-00012.
Twenty-two patients (mean age, 48.5 years) suspected of early chronic alcoholic pancreatitis, who had ductal changes mainly in the side branches, were followed by serial endoscopic retrograde pancreatography (ERP). Follow-up ranged from 1.1 to 11.9 years (mean, 5.4). Serial ERP revealed deterioration in six patients (27%), five of whom had outflow disturbance of the main pancreatic duct. On the other hand, five patients presented slight progressive changes restricted to the side branches and the remaining 11 patients showed no change. None of the 12 patients who abstained from drinking showed a deterioration of their pancreatogram. The deterioration of clinical symptoms was less frequently seen in patients with abstinence (5/12) than in those who continued drinking (10/10). This study suggests that a ductal abnormality mainly in the side branches may be an early sign of chronic alcoholic pancreatitis. Outflow disturbance of the main pancreatic duct might play an important role in the progression of the pancreatogram to an advanced stage. Abstinence is associated with a high probability of stabilization of both clinical symptoms and ductal changes.
22例疑似早期慢性酒精性胰腺炎的患者（平均年龄48.5岁），其导管改变主要在侧支，接受了系列内镜逆行胰胆管造影（ERP）检查。随访时间为1.1至11.9年（平均5.4年）。系列ERP显示6例患者（27%）病情恶化，其中5例主胰管有流出道障碍。另一方面，5例患者仅侧支出现轻微进展性改变，其余11例患者无变化。12例戒酒患者的胰胆管造影均未显示恶化。戒酒患者临床症状恶化的情况（5/12）比继续饮酒患者（10/10）少见。本研究表明，主要在侧支的导管异常可能是慢性酒精性胰腺炎的早期征象。主胰管流出道障碍可能在胰胆管造影进展至晚期中起重要作用。戒酒与临床症状和导管改变稳定的高概率相关。
