胰胆管汇合异常诊治进展及困惑  

Diagnoses and treatments of pancreaticobiliary maljunction:advances and controversies

作　　者：钱曼宁 陈功[1] Qian Manning;Chen Gong(Department of Surgery,Children's Hospital of Fudan University,Shanghai 201102,China)

机构地区：[1]复旦大学附属儿科医院外科,上海201102

出　　处：《中华小儿外科杂志》2024年第7期657-663,共7页Chinese Journal of Pediatric Surgery

基　　金：国家自然科学基金(81873545);上海市出生缺陷重点实验室开放基金(2022CSQX1005)。

摘　　要：胰胆管汇合异常(pancreaticobiliary maljunction,PBM)与胰、胆管的多种疾病相关,若不处理可发展为恶性疾病。共同管长度是诊断PBM的重要参数,不同年龄人群共同管长度标准有所不同。目前影像学诊断朝着功能影像方向发展,功能磁共振成像、超声内镜、胰胆管直视镜在诊断PBM方面有良好的应用前景。术中显影技术有助于PBM胆管远端精准切除;无明显胆管扩张PBM的治疗手段存在争议,肝外胆管切除、胆囊切除、内镜下括约肌切开等手术方式需要根据患儿具体情况选择。无论哪种术式,患儿术后均存在胆管癌变风险,术后需密切随访。Pancreaticobiliary maljunction(PBM)is associated with various biliary and pancreatic diseases.Non-treatment may lead to malignancy.Common channel length is an important parameter for diagnosing PBM and its value varies with age.Imaging diagnosis is currently evolving toward functional magnetic resonance,endoscopic ultrasonography and cholangioscopy.Intraoperative imaging modalities may facilitate precise resection of distal bile duct of PBM.A proper treatment of PBM without obvious bile duct dilation has remained controversial.Selecting extrahepatic bile duct resection,cholecystectomy and endoscopic sphincterotomy should be based upon specific patient conditions.Due to a high risk of postoperative residual bile duct cancer,close follow-ups are necessary.

关 键 词：胰腺 胰胆管汇合异常 磁共振胆胰管成像 

分 类 号：R726.5[医药卫生—儿科]