胰胆管合流异常与胆系癌的相关性探讨  

Investigation of the Correlation between Pancreaticobiliary Maljunction and Biliary Carcinoma

作　　者：韩新巍[1] 李臻[1] 张伟[2] 

机构地区：[1]河南省高校临床医学重点开放实验室郑州大学第一附属医院放射科,郑州市450052 [2]郑州市第一人民医院介入科

出　　处：《中国肿瘤临床》2008年第17期971-974,共4页Chinese Journal of Clinical Oncology

摘　　要：目的:探讨胰胆管合流异常(pancreaticobiliary maljunction,PBM)与胆系癌(胆囊癌和肝外胆管癌)的相关性。方法:回顾性分析1999年1月～2007年2月连续257例阻塞性黄疸(obstructive jaundice,OJ)患者行经皮肝穿刺胆管引流术(percutaneous transhepatic cholangiodrainage,PTCD)治疗的临床及影像学资料,其中PTCD术中胰管显影226、具例有不经伴皮有肝PB穿M刺的胆OJ道病钳例夹中活抽检取病8理9例资为料对者照3组5例,与,测31量例其伴共有同P管BM长的度O、J胆病胰例汇行合对角照度研,究确,诊分P析BMPB3M1例与。胆随系机癌的在相关性。结果:两组病例中胆系癌发生率存在显著性差异(P<0.05),PBM共同管长度、胆胰汇合角度对胆系癌发生率无显著影响(P>0.05),PBM汇合角度、汇合类型对并存的胆系癌分化程度无显著影响(P>0.05)。结论:PBM与胆系癌发生有显著相关性。Objective： To explore the correlation between pancreaticoblliary maljunction （PBM） and biliary carcinoma, including gallbladder carcinoma and extrahepatic biliary duct carcinoma. Methods： We retrospectively analyzed the clinical data and cholangiopancreatographic results of 257 consecutive patients with obstructive jaundice （O J） who underwent percutaneous transhepatic cholangiodrainage （PTCD） in our hospital from January 1999 to February 2007. The biliary and pancreatic ducts were visualized in 35 cases and these cases had complete pathological data obtained through percutaneous transhepatic cholangiobiopsy. We measured the length of common ducts and the confluence angle. Eventually, 31 cases were diagnosed as PBM. In order to evaluate the correlation between PBM and biliary carcinoma, we randomly drew 89 cases from the 226 OJ cases without PBM as the controls. Results： The biliary carcinoma incidence in cases with PBM was significantly higher than that in cases without PBM （P〈0.05）. The length of biliary ducts and the confluence angle had no significant influence on the incidence of biliary carcinoma （P〉0.05）. No correlation was found between PBM confluence types or angle and the differentiation of biliary carcinoma. Conclusion： PBM is closely related to biliary carcinogenesis.

关 键 词：胰胆管合流异常 经皮肝穿刺胆管造影术 胆系癌 相关性 

分 类 号：R656[医药卫生—外科学] R735.8[医药卫生—临床医学]