纤维胆道镜上胆总管下端开口的形态及功能

Observation on the shape and function of the orifice of common bile duct underflexible choledochoscopy

为了解胆总管下端开口形态及功能，通过应用纤维胆道镜对胆总管下端开口形态及功能作前瞻性研究，同时作胆道测压。结果发现：胆总管下端开口形态可归纳为４型：圆点型、放射型、不规则型和横裂型；当开口松驰时，易致胆道蛔虫、胆管炎症和结石复发；不规则型和横裂型开口时，胆道压力降低十二指肠乳头狭窄可分为功能型和器质型。

A prospective study on the shape and function of the orifice of common bileduct under flexible choledochoscopy was performed.The shape of common bile ductfell into following four categories:dot,radiating (converging),irregular and fissurehole.As the irregular or fissure hole types were relatively unfunctional,the bil-iary ascariasis,cholantitis and recurent billiary calculi were more likelyto be found.An endoscopic manometric technique was applied to the measurement of the pres-sure of biliary and shphicter of Oddi.The results demonstrated that the pressure of biliaryand sphincter in the types of irregular and fissure hole were lower,that thepressure in the stricture papillitis was higher.The stricture papillitis was divided into two types:functionalstenosis and organic stenosis.The former may be cured with medicines,the balloon dilator and sphineterotomy(papillotomy),while the latter with the balloon dilator and sphinctertomy.