胆总管、胰管汇合部的应用解剖

APPLIED HUMAN ANATOMY OF PANCREATICOBILIARY JUNCTION

为给经内镜逆行胆胰管造影、经内镜乳头括约肌切开术等临床诊断、治疗提供应用解剖学资料，对７０例人尸体的胆总管与胰管汇合部进行了解剖、测量并统计。结果胆总管入十二指肠角：成人４１．１±１．７５ｏ、儿童４０．１±１．７２ｏ，胆总管肠壁内段长度：成人１．０４±０．４２ｃｍ、儿童０．８９±０．６３ｃｍ；十二指肠大乳头位于十二指肠降部中１／３者４４例，占总例数的６７％，其余开口于降部的上１／３或下１／３；十二指肠大乳头至胃幽门间距：成人９．８４±１．５８ｃｍ、儿童８．２６±１．６４ｃｍ；至上颌中切牙间距：成人７４．５８±１．７７ｃｍ，儿童６９．６３±２．０８ｃｍ，胆总管、胰管汇合共同开口４１例，占分型数５０例的８２％，其余为分别开口。结果提示胆总管入角越小其肠壁内段长度越长，十二指肠大乳头位于降部中１／３后内侧壁者及胆总管与胰管共同开口者占多数。

With the stress on regional anatomy of pancreaticobiliary junction 70 human cadavers were dissected and measured, data being treated statistically. Results showed that the angle formed by common bile duct (CBD) at the entranec into duodenum was 41.1±1.75 o in adult and 40.1±1.72 o in child;intramural length of CBD measured 1.04±0.42cm and 0.89±0.63cm respectively;the major papilla situated at inner lateral side of middle 1/3 of descending duodenum in 67% (n=44), the rest at inner lateral side of upper or lower 1/3; distance from major papilla to pylorus maintained 9.84±1 58cm in adult and 0.89±0.63cm in child, that to the upper incisive tooth being 74.58±1.77cm and 69.63±2.08cm accordingly; a common path formed by the two ducts before entering in 82% (n=41/50). It is concluded that the smaller the angle the longer the intramural CBD.The significance of duodenal papilla is discussed.