胰管结石的分型及手术治疗  

Classification and surgical treatment of pancreatic duct stone

作　　者：刘雷[1] 安孟增[1] 卢海明[1] 张其顺[1] 

机构地区：[1]广西医科大学第四附属医院普通外科二病区,柳州545005

出　　处：《临床外科杂志》2014年第9期673-675,共3页Journal of Clinical Surgery

摘　　要：目的：探讨胰管结石的分型及手术方法。方法对8例行手术治疗的胰管结石合并慢性胰腺炎或胰腺癌患者病历资料进行分析。8例患者术前均行腹部B超、上腹部CT平扫＋增强或磁共振胆胰管水成像（MRCP）检查以明确诊断。其中Ⅰ型2例，采用胰头十二指肠切除术；Ⅱ型1例，采用胰尾切除＋脾切除＋胰管空肠吻合术；Ⅲ型5例，采用胰管切开取石并胰管空肠吻合术。结果8例均成功手术，1例术后并发胰漏，经非手术治疗后好转；5例糖尿病患者术后3例血糖恢复正常。结论胰管结石发病率虽然不高，但常合并胰腺炎、糖尿病甚至胰腺癌，后果严重，依胰管结石部位分型并选择合理的手术方法极为重要。Objective To discuss the classification and surgical treatment of pancreatic duct stone.Methods The data of 8 cases of pancreatic duct stone combined with chronic pancreatitis or pan-creatic cancer were reviewed.All patients＆#39;diagnoses were confirmed by abdominal type-B ultrasound,plain and contrast enhanced CT scan of the upper abdomen and magnetic resonance cholangio paneretography （MRCP）.Among them,two type I cases underwent pancreatoduodenectomy,one type II case underwent pancreatic cauda resection,splenectomy and pancreaticojejunostomy,and five type III cases received pan-creatic duct lithotomy and pancreaticojejunostomy.Results All surgeries were successfully performed. One case is complicated with pancreatic leakage after operation and recovered after non-surgical treatment. Three out of five cases with diabetes recovered with normal blood sugar.Conclusion Although the inci-dence of pancreatic duct stone is low,it＆#39;s commonly complicated with pancreatitis,diabetes,or even pancre-atic cancer,which results in serious consequences.Based on the location of stones,classification is very im-portant in the selection of appropriate procedures.

关 键 词：胰管结石 分型 手术治疗 

分 类 号：R657.5[医药卫生—外科学]