慢性胰腺炎胰、胆管梗阻的处理(附6例报告)

Chronic pancreatitis and pancreatic cancer

在３７例慢性胰腺炎病人中，８例合并胆道梗阻（２２％），４例合并主胰管梗阻（１１％）；６列同时或异时合并胰、胆管梗阻（１９％）。其中１例在发现胰管扩张１年后，出现胆管梗阻；２例同时发现胰、胆管梗阻。３例因黄疸在外院先行胆道手术，术后腹痛持续，影像检查证实尚伴有胰管梗阻，而再次行胰管减压手术。未合并胆石和（或）胆管炎的单纯胆道梗阻一般不引起严重的腹痛。对腹痛症状较重，而又无胆管结石的慢性胰腺炎病人应特别警惕是否同时合并胰管梗阻。

Treatment of chronic pancreatitis with obstruction of the main pancreatic duct and common bile duct.Report of 6 cases.Guo Kejian,Shen Kui,Tian Yulin,et al.Department of Surgery,First Affiliated Hospital,China Medical University,Shenyang 110001 Among 37 patients with chronic pancreatitis,eight(22%)had obstruction of the common bile duct(CBDO),four(11%)had obstruction of the main pancreatic duct(MPDO),and six(19%)had both MPDO and CBDO at the same or different time.One suffered CBDO at 1 year after MPDO,two had MPDO and CBDO simultaneously,and three patients were treated by choledochojejunostomy because of obstructive jaundice in other hospitals,but abdominal pain was persistent postoperatively,MPDO was demonstrated,so pancreaticojejunostomy was performed again.There was no severe abdominal pain in CBDO without cholelithiasis or/and cholangitis.The patient suffered from chromic pancreatitis with severe abdominal pain but without biliary calculi should be alert whether complicated MPDO or not.