十二指肠乳头异位与胰胆管合流异常的相关性分析

The Relative Analysis Between Duodenal Papilla Ectope and Pancreaticobiliary Maljunction

目的探讨十二指肠乳头异位(duodenal papilla ectope,DPE)与胰胆管合流异常(pancreaticobiliary maljunction,PBM)的临床病理联系,提高临床对DPE的认识,以利于早期诊断PBM。资料与方法回顾性分析1999年1月至2007年2月间连续257例因阻塞性黄疸经PTC行介入治疗患者的临床与影像学资料,其中确诊PBM31例。反复测量PBM患者的共同管长度、汇合角度,并判断十二指肠乳头的位置,对结果进行统计学处理、分析。结果乳头位置对共同管长度有显著影响(P<0.05),而不影响胆胰管汇合角度大小(P>0.05)。结论PBM患者十二指肠乳头多数向降部中段1/3以远异位,并影响共同管长度;异位越远,共同管越长。DPE与PBM有病因学相关性,发现DPE有利于以无创技术早期诊断PBM。

Objective To investigate the clinical pathologic relationship between duodenal papilla ectope （DPE） and pancreaticobiliary maljunction （PBM）. To improve the information of DPE and early diagnosis of PBM. Materials and Methods From January 1999 to February 2007,the clinical data and cholangiopancreatographic results of consecutive 257 patients with obstructive jaundice （O J） received PTC therapy were analyzed retrospectively. 31 cases were radiologically diagnosed as PBM. The length of common duct and the confluence angle were measured and the duodenal papilla＇s site was observed. All the results were analyzed statistically. Results The duodenal papilla＇s site has significant influence on the length of common duct（ P value 〈 0.05 ）, but no influence on the confluence angle（ P value 〉 0.05 ）. Conclusion These results suggest that the duodenal papillag site of PBM cases are facilitative to ectope to the distal middle 1/3 of descending duodenum. The distaler the ectopic location of duodenal papilla is, the longer the common duct is. DPE has etiological correlation with PBM. Detecting DPE is facilitate to diagnosis PBM at early stage.