青少年胰胆管畸形ERCP表现特点及临床意义

ERCP Features of Pancreatico biliary Ductal Abnormalities and Its Clinical Implication in Adolescents

目的：探讨青少年胰胆管畸形的ＥＲＣＰ表现特点及其与胰胆系病变的关系。方法：应用Ｘ线电视录像和多轴位透视、摄片等技术研究２９例异常胰胆管连接（ＡＰＢＤＵ），８例胰腺分裂（ＰＤ）和３１例胆囊管低位汇入（ＬＯＣＤ）患儿的ＥＲＣＰ表现特点及其伴发疾病情况，并与５０例正常胰胆管连接者（对照组）比较。结果：①ＡＰＢＤＵ组胆管炎、胆管囊肿、慢性胰腺炎的发生率明显高于对照组（Ｐ＜０．０５）。ＡＰＢＤＵ组合并慢性胰腺炎的患儿以胰管增粗、迂曲等改变为主，而对照组主要表现为胰头变硬或增大等。②ＰＤ组慢性胰腺炎的发生率显著增高（Ｐ＜０．０１）。③ＬＯＣＤ组慢性胰腺炎和胆系结石的发生率显著增高。结论：ＥＲＣＰ是诊断胰胆管畸形的有效手段，胰胆管畸形与多种胰胆系病变存在病因学联系。

Objective: To characterize pancreatico biliary ductal abnormalities in adolescents and correlate to the features clinically. Methods: The ERCP features of 68 patients with pancreatico biliary ductal abnormalities and 50 controls were analyzed on video. The incidence of pancreatico biliary disease in each group was calculated. Results: There were 29 cases with anomalous pancreatico biliary ductal union(APBDU), 8 pancreas division(PD) and 31 low cystic duct entry(LOCD). The incidence of cholangitis, choledochal cysts and chronic pancreatitis in APBDU group was significantly higher than that of the control group. The incidence of chronic pancreatitis in PD group was significantly higher than that in control group ( P < 0.01 ). The incidence of chronic pancreatitis and gallstones in LOCD group was higher than that of the control group. Conclusions: ERCP is an effective diagnostic modality of pancreatico biliary abnormalities. The anomalous pancreatico biliary morphology correlate clinically with high incidence of pancreatico biliary diseases.