胰腺分裂症的ERCP诊断与治疗价值(附10例临床分析)  

The diagnostic and therapeutic value of ERCP in pancreatic divisum

作　　者：李兆申[1] 许国铭[1] 孙振兴[1] 

机构地区：[1]上海第二军医大学附属长海医院消化内科,上海200433

出　　处：《胃肠病学和肝病学杂志》2001年第1期69-71,共3页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的　探讨胰腺分裂症 (PancreaticDivisum ,PD)ERCP诊断与治疗价值。方法　总结分析了我院经ERCP确诊及治疗的 10例PD病人临床资料。结果　PD占我院同期ERCP的 2 % ,10例患者均有慢性腹痛症状 ,5例病人有复发性胰腺炎病史 ,10例患者ERCP所见 :主胰管长度 1.5～ 4.2cm ,平均 2 .2 9cm ,其末端呈细树枝样 ,9例副乳头膨大 ,开口明显 ,用针状或尖头形造影导管行副乳头插管 ,均显影 ,副胰管长度 8.5～ 14 .2cm ,平均 12 .1cm ,均有不同程度的扩张 ,1例乳头开口部狭窄 ,并见副胰管头部有一 6× 4mm囊性扩张 ,主、副胰管间无汇合交通支 ,本组病人中 5例经副乳头行支架引流治疗 ,3例副乳头扩张 ,1例行副乳头切开术 ,随访 3～ 36个月 ,8例病人腹痛明显缓解 ,5例有复发性胰腺炎病史者未再复发 ,1例病人术后 8月因胰管支架阻塞而更换支架。Aim To evaluate the diagnostic and therapeutic value of ERCP in pancreatic divisum(PD).Method The clinical data in 10 patients with PD which was diagnosed and treated by ERCP in our hospital were summarized.Result All ten patients with PD suffered from chronic abdominalgia and accounted for 2% of the total patients performed ERCP.Five of them had recurrent pancreatitis.The ERCP findings of the 10 patients with PD were as follows:the length of main pancreatic duct with its gracile dendritic terminal was 1.5～4.2 cm and averaged 2.29 cm;9 of 10 patients' accessory papilla were intumescent and their debouchure were patent and visualization of minor pancreatic duct showed that all of the 9 patients developed dilation to some degree and the length of minor pancreatic duct was 8.5～14.2 cm and averaged 12.1 cm.One patient's acessory papillary debouchure was stenotic.At the head of the minor pancreatic duct there was a saccular dilation sized 6×4 mm 2,and there was no communicanting between the main and minor pancreatic duct.Five patients with PD performed minor pancreatic duct drainage by stent,3 performed accessory papillary dilataization and one patient performed accessory papillotomy.In the following 3～36 months after ERCP,8 patients with chronic abdominalgia was remittent,Five patients with recurrent pancreatitis had no recurrence and one patient performed stent replacement 8 months later because of stent blockage.Conclusion ERCP has significant value in the diagnosis and therapy of PD.

关 键 词：胰腺分裂症 ERCP 诊断 治疗 

分 类 号：R657[医药卫生—外科学]