胰管结石诊治方法的探讨

Diagnosis and treatment for pancreatic duct stone

目的 探讨胰管结石症的诊断、治疗的方法和措施。方法 对 1980 - 2 0 0 1年收治的胰管结石 39例进行回顾性分析。结果 胰管结石主要表现为反复发作上腹痛伴腹泻、消瘦及糖尿病等胰腺内外分泌功能不全症状 ,主要依据B超、CT、腹部平片及ERCP等多种影像学检查联合应用确定诊断。手术治疗 31例 ,行胰管切开取石、胰管空肠Roux -en -Y吻合术 2 2例 ,其中伴黄疸同时行胆管探查、T管引流术 5例 ,胆管空肠侧侧吻合 3例 ;胰头局部切除 2例 ;胰十二指肠切除 3例 ;胰体尾切除 3例 ,其中行胰体空肠吻合术 2例 ,效果满意。结论 B超、CT、腹部平片及ERCP等多种影像学检查联合应用可确定诊断 ,其中B超检查为首选方法 ,确诊后应尽早手术 ,众多手术方式中胰管切开取石、胰管空肠Roux -en

Objectives To explore the methods of diagnosis and treatment for pancreatic duct stone.Methods Experience of diagnosis and treatment for pancreatic duct stone in 39 patients form 1980's up to 2001's were retrospectively analyzed by us.Results The main symptoms of the disease are pain in midsection along with diarrhea,thin and some symptoms of diabetes,cauaed by dysfunction of inside an outside secretion of pancreas.The diagnosis are confirmed by the methods combined with B-type ultrasonic,CT or ERCP.31 cases were operated,22 with splitting the pancreatic duct and fetching stone and pancreaticojejunostomy,of which,5 patients carrying with bile duct exploration and drainage with T tudb;3 patients with cholangiojejunostomy;2 cases with local excising of head of pancreas;3 cases with pancreatoduodenctomy;3 patients with resection of body and trail of pancreas.The operative effects are satisfactory.Conclusions The diagnosis of the disease is confirmed by the methods combined with B-type ultrasonic,CT or ERCP,but the first choicst choice is B-type ultrasonic.Splitting the pancteatic duct and fetching stone,pancteato jejunostomy is the operation of the first choice.