胰管结石诊治体会(附29例报告)  

The diagnosis and treatment of pancreatic duct stones in 29 cases

作　　者：涂朝勇[1] 刘雷[2] 骆晓鸿[3] 黄志勇[4] 

机构地区：[1]浙江省丽水市中心医院肝胆外科,323000 [2]广西医科大学附属第四医院肝胆外科 [3]贵州省人民医院肝胆外科 [4]华中科技大学同济医学院附属同济医院普外科

出　　处：《中华普通外科杂志》2005年第11期696-697,共2页Chinese Journal of General Surgery

摘　　要：目的探讨胰管结石的诊断与治疗。方法回顾性分析29例胰管结石的临床资料。结果21例有慢性胰腺炎病史,其中12例有胆道结石,合并胰腺癌2例,B超诊断正确率89.7%(26/29),CT诊断正确率65.0%(13/20),内镜逆行性胆管胰管造影术及磁共振胰胆管成像诊断正确率均为100%(6/6及4/4)。行内镜下括约肌切开术取石6例,胰管切开取石、胰管空肠Roux-en-Y吻合术16例,十二指肠乳头成形、胰石取出术3例,胰管切开取石、胰腺假性囊肿空肠Roux-en-Y吻合2例,胰头十二指肠切除1例,剖腹探查术1例。结论慢性胰腺炎、胆石症是形成胰管结石的主要原因,影像学检查是术前诊断的主要方法,胰管切开取石、胰管空肠吻合是胰管结石主要手术方式。Objective To explore the diagnosis and treatment of pancreatic duct stones. Methods Clinical data of 29 cases of pancreatic duct stones were analyzed retrospectively. Results Chronic pancreatitis was complicated in 21 cases, cholelithiasis in 12, pancreatic cancer in 2 . The correct diagnosis rate of ultrosonography, CT, ERCP and MRCP was 89.7% （26/29）, 65. 0% （13/20）, 100% （6/6） and 100% （4/4） respectively. Six cases underwent EST, 16 cases did transpancreatic duct lithotomy plus Roux-en-Y pancreaticojejunostomy, Three cases did sphincteroplasty, pancreaticoduodenectomy and exploratory laparotomy were performed in one each. Conclusions Chronic panreatitis cholelithiasis is the main causes of pancreatic duct stones. Imaging examinations help to make diagnosis preoperatively. Transpancreatic duct lithotomy plus Roux-en-Y pancreaticojejunostomy is the therapy of choices for patients with pancreatic duct stones.

关 键 词：胰腺疾病 结石 诊断 外科手术 

分 类 号：R657.5[医药卫生—外科学] R656[医药卫生—临床医学]