用于诊断胰胆管合流异常的内镜超声检查

Endoscopic ultrasonography for diagnosing anomalous pancreaticobiliary junction.

作者信息

Sugiyama M, Atomi Y

机构信息

First Department of Surgery, Kyorin University, School of Medicine, Tokyo, Japan.

出版信息

Gastrointest Endosc. 1997 Mar;45(3):261-7. doi: 10.1016/s0016-5107(97)70268-2.

DOI:10.1016/s0016-5107(97)70268-2

PMID:9087832

Abstract

BACKGROUND

Anomalous pancreaticobiliary junction (a long common channel) is associated with choledochal cyst or biliary malignancy. We conducted a prospective study to assess the diagnostic value of endoscopic ultrasonography for anomalous pancreaticobiliary junction.

METHODS

In 188 adult patients with pancreatobiliary disease, the length of the common channel demonstrated by endoscopic ultrasonography was compared with that demonstrated by ERCP. In 25 patients with anomalous pancreaticobiliary junction (the common channel > 15 mm on ERCP), diagnostic accuracy of endoscopic ultrasonography for associated pancreatobiliary diseases was evaluated.

RESULTS

On endoscopic ultrasonography, the length of the common channel measured 16.3 +/- 5.8 mm (4 of 27 mm) in patients with anomalous junction; 12 mm or longer in 22 (88%) of 25 patients. In patients with a normal junction, endoscopic ultrasonography demonstrated the channel to be shorter than 7 mm. Endoscopic ultrasonography detected choledochal cyst (in 19 patients), gallstones (in 7), and acute pancreatitis (in 2). This imaging precisely differentiated gallbladder lesions, including carcinoma (4 patients) and mucosal hyperplasia (10 patients) in 14 of 16 patients. Endoscopic ultrasonography could be performed safely in outpatients.

CONCLUSIONS

Endoscopic ultrasonography is useful imaging method for patients with suspected anomalous pancreaticobiliary junction.

摘要

背景

胰胆管汇合异常（长共同通道）与胆总管囊肿或胆管恶性肿瘤相关。我们进行了一项前瞻性研究，以评估内镜超声对胰胆管汇合异常的诊断价值。

方法

在188例患有胰胆管疾病的成年患者中，比较了内镜超声显示的共同通道长度与内镜逆行胰胆管造影（ERCP）显示的长度。在25例胰胆管汇合异常患者（ERCP显示共同通道>15mm）中，评估了内镜超声对相关胰胆管疾病的诊断准确性。

结果

在内镜超声检查中，汇合异常患者的共同通道长度为16.3±5.8mm（27mm中的4例）；25例患者中有22例（88%）为12mm或更长。在汇合正常的患者中，内镜超声显示通道短于7mm。内镜超声检测到胆总管囊肿（19例）、胆结石（7例）和急性胰腺炎（2例）。这种成像方法能精确区分胆囊病变，包括16例患者中的14例癌症（4例）和黏膜增生（10例）。内镜超声可在门诊患者中安全进行。