18例胰腺分裂症的临床特点分析  

Clinical characteristics of 18 cases of pancreas divisum

作　　者：杨帅[1] 张游[1] 李闻[1] 令狐恩强[1] 王永华[1] 郭明洲[1] 

机构地区：[1]中国人民解放军总医院消化内科,北京100853

出　　处：《胃肠病学和肝病学杂志》2015年第5期590-592,共3页Chinese Journal of Gastroenterology and Hepatology

基　　金：国家重大科学研究计划(973计划No.2012CB934002;2015cb553904);国家高技术研究发展计划(863计划No.SS2012AA020314;SS2012AA020821;SS2012AA020303);国家重大科学仪器设备开发专项(Grant No.2011YQ03013405);国家自然科学基金(NSFC No.81402345;81121004;81490753)

摘　　要：目的通过分析胰腺分裂症(pancreas divisum,PD)的临床特点,为PD的鉴别诊断提供参考。方法回顾性分析中国人民解放军总医院近10年来收治的18例PD患者的临床资料,主要指标包括临床表现、影像学检查及治疗方法。结果 18例PD患者均以反复发作的上腹痛为主要临床表现,13例(72.22%)有慢性胰腺炎急性发作史,4例(22.22%)有急性复发性胰腺炎史,1例(5.56%)患者仅表现为慢性胰源性腹痛。18例患者均行内镜下逆行性胰胆管造影(endoscopic retrograde cholangiopancreatography,ERCP)确诊,其中8例行胰腺CT,检出率为37.50%(3/8),9例行MRCP,检出率为33.33%(3/9)。治疗手段包括结合ERCP行副乳头扩张术、副乳头括约肌切开术及胰管支架置入术(16例,88.89%),内科保守治疗(2例,11.11%),症状均得到有效缓解。结论PD患者的主要症状是反复发作性上腹疼痛,ERCP是PD诊断的"金标准",内镜下治疗是该病主要治疗手段。Objective To reveal the clinical characteristics of pancreas divisum （PD）. Methods Clinical data of 18 cases of PD patients were collected and analyzed from 2005 to 2014 hospitalized in the Chinese PLA General Hospi- tal. Results Frequent abdominal pain was the major symptom, 13 cases （72.22%） manifested as acute occurrence of chronic pancreatitis, 4 cases （22.22%） were diagnosed as acute recurrent pancreatitis and 1 case （5.56%） only ap- peared recurrent abdominal pain. Three of eight cases （37.50%） were diagnosed by CT, and three of nine cases （33.33%） were found by MRCP. All patients were finally determined by ERCP. Sixteen of 18 patients were cured by minor papilla-sphincter dilatation, minor papilla sphincterotomy or placed stent under endoscopy. Two cases were ac- cepted conserved treatment. Conclusion Recurrent abdominal pain is the main symptom of PD patients, ERCP is the best diagnostic method. Endoscopic therapy is the main treatment method of PD.

关 键 词：胰腺分裂症 内镜逆行性胰胆管造影 副乳头扩张术 副乳头切开术 胰管支架置入术 

分 类 号：R576[医药卫生—消化系统]