合并胰胆管合流异常的急性胆源性胰腺炎32例分析

Analysis of 32 cases of acute biliary pancreatitis with pancreaticobiliary maljunction

目的通过磁共振胰胆管成像检查评价成人胰胆管合流异常并探讨其和急性胆源性胰腺炎发生的关系。方法对照观察伴有胰胆管合流异常与不伴胰胆管合流异常之成人急性胆源性胰腺炎患者153例，比较其保守治疗前后的各项肝功能指标的差别。结果通过磁共振胰胆管成像检出的32例急性胆源性胰腺炎患者合并胰胆管合流异常，与其余121例不伴胰胆管合流异常的成人急性胆源性胰腺炎患者比较。保守治疗后胰胆管合流异常（PBM）组和不伴胰胆管合流异常（NPBM）组的TB、ALT、AST、ALP、GGT都明显降低，其中ALT、AST、GGT的变化差异有统计学意义（P〈0．05）。PBM组的ALT、AST和GGT都高于NPBM组，差异有统计学意义（P〈0．05）。结论胰胆管合流异常是导致急性胆源性胰腺炎的重要原因之一，MRCP作为一种无创的胆胰管道系统成像技术对于胰胆管合流异常的研究是一种安全、可靠的检查方法。

Objective To investigate the relationship between acute biliary pancreatitis and pancreaticobiliary maljunction and the role of magnetic resonance cholangiopancreatography（MRCP） in evaluation of pancreatico biliary maljunction. Methods To compare the liver function indicators of different groups of acute biliary pancreatitis patients（ 153 cases） associated with pancreatico biliary maljunction and without pancreatico biliary maljunction be- fore and after the conservative treatment. Results The 32 acute biliary panereatifis patients with panereatico biliary maljunction detected by MRCP were compared with the 121 cases without panereatieo biliary maljunetion . The ALT, AST, GGT after conservative treatment in both group of pancreatico biliary maljunction and Npancreatico bili- ary maljunction were significantly decreased（P 〈 0.05）. ALT, AST and GGT of pancreatico biliary maljuncfion group were higher than that of Npancreatico biliary maljunction group with statistical significance （ P 〈 0.05 ）. Conclusions MRCP as a noninvasive cholangiopancreatography study of pancreatico biliary maljunction is a safe and reliable examination method, pancreatico biliary maljunction is one of the important causes of acute biliary pan- creatitis.