隐性胰胆逆流在胆囊癌早期诊断中的意义  

Value of occult pancreaticobiliary reflux on early diagnosis for patients with gallbladder cancer

作　　者：巨邦律[1] 陈永兵[1] 张维一[1] 于聪慧[1] 余昌中[1] 聂洪峰[1] 

机构地区：[1]北京军区总医院肝胆外科,北京100700

出　　处：《岭南现代临床外科》2016年第1期21-23,共3页Lingnan Modern Clinics in Surgery

摘　　要：目的探讨隐性胰胆逆流在胆囊癌早期诊断中的价值。方法回顾性分析我院2007年06月~2011年04月经术中证实胰胆合流正常的86例胆囊癌患者术前影像学资料及术中胆汁淀粉酶水平,并与术中探查结果、及病理诊断进行对比分析。测定随机抽取同期56例行手术治疗胆囊结石胆囊胆汁淀粉酶及22例行PTCD术肝门部胆管癌患者胆汁淀粉酶水平。结果本组86例胆囊癌患者,胆汁淀粉酶测定值为752.6±341.8 U/L,其中61例（70.1%）胆汁淀粉酶明显高于血清淀粉酶正常上限。胆囊结石患者胆汁淀粉酶测定值为76.7±68.3.8 U/L。肝门部胆管癌患者未发现胰胆逆流。结论胆囊癌中隐性胰胆逆流的发生率较高,胰胆逆流在胆囊癌发病过程中可能具有重要作用。Objective To study the value of occult pancreaticobiliary reflux in the early diagnosis of patients with gallbladder cancer. Methods The date of 86 patients of normal pancreaticobiliary junction evidenced by operative cholangiography with gallbladder cancer in our hospital from June 2007 to April 2011 were retrospectively analyzed. The information of imageology and the bile amylase level of cystic was detected,and were compared with the intraoperative exploration findings and postoperative pathological diagnosis. The bile amylase levels of 56 consecutive patients with cholecystolithiasis and 22 hilus holangiocarcinoma were detected. Results The mean（SD） biliary amylase level of 86 patients of gallbladder cancer was 752.6（341.8） U / L, and cholecystolithiasis was 76.7（68.3） U / L. 61（70.1%）of gallbladder cancer the biliary amylase level above that of normal serum. Conclusion The incidence of occult pancreatobiliary reflux were higher with gallbladder carcinoma,and pancreaticobiliary reflux that might play an important role in the pathogenesis of gallbladder cancer.

关 键 词：胆囊癌 隐性胰胆逆流 淀粉酶 

分 类 号：R735.8[医药卫生—肿瘤]