胎儿胰胆管解剖研究  

Anatomy of fetal pancreaticobiliary

作　　者：陈风[1] 吕毅[1] 汪健[2] 黄顺根[2] 王兴东[2] 

机构地区：[1]西安交通大学医学院附属第一医院肝胆外科,西安710061 [2]苏州大学附属儿童医院普外科,江苏苏州215003

出　　处：《中国临床解剖学杂志》2009年第6期665-667,共3页Chinese Journal of Clinical Anatomy

基　　金：江苏省135工程重点人才项目(2003098)

摘　　要：目的:探讨胎儿胰胆管合流的类型及十二指肠乳头的形状和位置。方法:选取经水囊引产死后6h内的新鲜胎儿36例,胎龄4月～9月。切取包括胆囊、胆总管、十二指肠、胰腺的标本,观察十二指肠乳头的位置、形状。再置于福尔马林中24h,脱水、透明、浸腊、包埋。组织块以乳头为中心,横行连续切片,厚6μm,每隔5张选1张,作HE染色。显微镜下观察胰胆管合流的类型。结果:(1)十二指肠大乳头半球形58.1%(21例),圆柱形25%(9例),扁平形16.9%(6例)3种形态。乳头位于十二指肠降部上1/3部8.3%(3例),中1/3部69.4%(25例),下1/3部19.4%(7例),远部2.9%(1例)。(2)存在U、V、Y和异常合流4种胰胆管合流方式,其中以Y型66.7%(24例),V型19.4%(7例),U形11.1%(4例),APBDU2.8%(1例)。结论:乳头形态位置及胰胆管合流的类型变化较多,了解这一解剖在临床有重要的意义。Objective： To investigate anatomic features of fetal pancreaticobiliary and duodenal papilla. Mot.hods： 36 foetus with the fetal ages of 4 to 9 months, 6 hours after death by induction of labor with water bag, were studied. The gallbladder, common bile duct, pancreatic duct and duodenum of them were removed and preserved in 10% buffered formaldehyde solution for 24 hours. The location and shape of the greater duodenal papilla were observed, and then serial sections of the specimens, with the thickness of 6 μm, were performed and HE stained, and followed by the observation of the union of pancreatic and bile common ducts under the microscope. Resultas： 1） Major duodenal papilla showed the shapes ofhemispheroid （58.1%）, circular cylinder （25%） and applanation （16.9%）, which located at the upper pars descendens duodenum （8.3%）, the middle pars descendens duodenum（69.4%）, the lower pars descendens duodenum（19.4%） or the farer（2.9%）. 2） The types ofpancreaticobiliary ductal union could be classified into four types： ＂Y＂ in 24 specimens （66.7%）, ＂U＂ in 4 specimens （11.1%） ,＂V＂ in 7 specimens （19.4%） and APBDU type in 1 specimens （2.8%）. Coneltmions： Pancreaticobiliary ductal union is variable and individual.

关 键 词：胰胆管合流 水囊引产 胎儿 十二指肠大乳头 

分 类 号：R322.48[医药卫生—人体解剖和组织胚胎学]