胰管结石诊治13例报告

The diagnosis and treatment of pancreatolithiasis:a report of 13 cases

目的探讨胰管结石症的诊断与治疗。方法回顾性总结１９８７～１９９７年６月收治的胰石症患者１３例，其中手术治疗１１例。结果胰石症多以上腹痛为首发症状，术前Ｂ型超声、ＥＲＣＰ、ＣＴ等都可成功诊断，其中Ｂ型超声为首选检查方法，ＥＲＣＰ可清晰显露胰管结石，对本病诊断有特殊临床意义。本组行胰管切开取石、胰管空肠ＲｏｕｘｅｎＹ吻合术１１例，其中加做Ｏｄｄｉｓ括约肌成形术３例，加做胰腺囊肿穿刺针吸术３例，效果良好。结论Ｂ型超声为诊断胰石症的首选检查法，首选术式为胰管切开取石。

Objective To evaluate the method of diagnosis and choice of treatment for pancreatolithiasis.Methods From 1987 to June 1997,13 patients with pancreatolithiasis were hospitalized,among them 11 cases underwent surgical therapy.A retrospective analysis was made. Results Epigastic pain was the first symptom of the patients with pancreatolithiasis.Ultrasonography was a first line examination and usually had definite result in the diagnosis of pancreatolithiasis. ERCP clearly showed the pancreatic duct stone.Eleven patients underwent pancreotolithotomy plus side to side Roux en Y pancreaticojejunostomy.In 3 cases sphincteroplasty was added.Three underwent paracentesis of the pancreatic cyst. Conclusions Ultrasonography was very effective in the diagnosis of pancreatolithiasis, and pancreatolithotomy plus side to side Roux en Y pancreaticojejunostomy usually results in a cure of the disease.