胰管结石11例诊治体会

THE DIAGNOSIS AND MANAGEMENT OF PANCREATIC DUCT STONES:A REPORT OF 11 CASES

目的探讨胰管结石的诊断与治疗。方法对2001～2007年间11例胰管结石患者的临床资料进行回顾性分析。结果胰管结石患者均以上腹痛为主要首发症状且合并慢性胰腺炎,多数有内、外分泌功能障碍。B超、CT、ERCP及MRCP均可明确诊断。6例行胰管切开取石、胰管空肠Roux-en-Y吻合术,3例胰体尾部结石行胰体尾切除、胰断端套入空肠端Roux-en-Y吻合术;2例行胰十二指肠切除术,1例胰头部结石行胰管切开取石,主胰管内置T型管引流。结论:B超、CT及MRCP是诊断胰管结石最主要的手段。外科手术治疗仍是目前治疗胰管结石的主要方法。手术方式的选择主要取决于胰管结石的部位、主胰管有无狭窄及是否合并胰腺癌。

Objective To sum up the experience in the diagnosis and treatment of pancreatic duct stones. Methods The clinical date of 11 patients treated in our hospital hospital form 2001 -2007 were retrospectively analyzed. Results Epigatric pain was the first symptome in all patients, and chronic pancreatitis was associated, most of patients associated with exocrine and endocrine functional disturbance. The disease can be diagnosed by B-type ultrasonography, CT,ERCP and MPCP. Six of 11 cases underwent pancreatolithotomy plus side to side Roux-en-Y pancreaticojejunostomy. Distal pancreatectomy and pancreatolithotomy with Roux-en-Y pancreaticojejunostomy were performed on three patients, pancreatoduodeneetomy on two patients, pancreatolithotomy plus pancreatic duct exploration and T-tube drainage on one patient. Conclusion B-type ultrasonography, CT, ERCP and MPCP are most useful diagnostic methods;Surgical management is still primary treatment method for pancreatic duct stone. Surgical procedures should be selected according to the location of the pancreatic duct stones,stenosis of the main pancreatic duct and pancreatic duct stonesassociated with or without pancreatic carcinoma.