47例胆胰管合流异常患者的临床特点分析

The analysis of clinical characteristics from 47 cases of pancreaticobiliary maljunction patients

目的了解该院经内镜逆行胰胆管造影（ERCP）患者中胰胆管合流异常（PBM）的检出率及临床特点。方法回顾性统计该院2006~2011年检查的9 102例ERCP患者。统计这些患者中PBM的发生情况,分析PBM的特征。结果 9 102例ERCP患者中,共诊断PBM患者47例,占ERCP患者的0.5%。47例PBM患者中,男性14例,女性33例,男∶女=1∶2.4,男性显著少于女性（P〈0.05）;年龄7~77岁,平均（44.7±15.0）岁。47例患者中,5例胰管汇流入胆管（10.6%）;38例胆管汇流入胰管（80.9%）;4例复杂型（8.5%）。合并胆管结石16例（34%）,合并胆管癌9例（19.1%）,合并急性胰腺炎4例（8.5%）,慢性胰腺炎2例（4.3%）,胆总管囊状扩张4例（8.5%）。结论胰胆管合流异常是临床较少见的先天性解剖变异;ERCP是诊断PBM的有效方法。74.5%的PBM有合并症,其中19%合并胆管癌。

[Objective]To research the check-out rate and clinical characteristics of pancreaticobiliary maljunction（PBM） in the ERCP patients in our hospital. [Methods]We investigated 9102 cases of consecutive ERCP patients from 2006 to 2011 in our hospital, and analyzed the incidence of PBM, and its characteristics. [Results]Among 9102 cases of ERCP patients, 47 patients were diagnosed as PBM, accounting for 0.5% of the ERCP patients. Among these 47 cases, male cases were 14, female 33, and the ratio of male to female was 1∶2. 4. Male patients with PBM was significantly less than female（P 0.05）. The age of the 47 cases was from 7 years old to 77 years old, with the average age of（44.7±15.0） years old. Within these 47 cases of PBM patients, there were 5 cases of pancreatic duct entering bile duct（10.6%）, 38 cases of bile duct entering pancreatic duct（80.9%）, 4 cases of complex type（8.5%）. 16 cases combined with bile duct stone（34%）, 9 cases with cholangiocarcinoma（19.1%）, 4 cases with acute pancreatitis（8.5%）, 2 cases with chronic pancreatitis（4.3%）, and 4 cases with cystic dilatation of common bile duct（8.5%）. [Conclusion]PBM is a rare congenital clinical anatomical variations, and ERCP is an effective method for the diagnosis of PBM. 74.5% of the PBM have complications, 19% of which combined with cholangiocarcinoma.