Clinical Analysis of Pancreatolithiasis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

Corresponding?author：

Keywords：

胰腺結石; 診斷; 治療

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

目的探討胰管結石的診斷、治療及發病原因。
方法回顧分析1998年1月1日至2004年11月31日期間收治的有完整病史資料的88例胰管結石患者的臨床特點、診斷和治療方法。
結果88例患者病史不典型，以上腹部疼痛最常見，所有病例均伴有慢性胰腺炎。B超檢查81例，診斷為胰管結石76例，胰腺鈣化5例； CT檢查51例，診斷為胰管結石47例，鈣化4例，其中有5例疑伴胰腺癌； MRCP檢查47例，診斷為胰管結石45例，胰腺鈣化1例，胰腺鈣化伴胰管擴張1例，其中6例疑伴胰腺癌。56例行手術治療，53例痊愈出院，2例好轉出院，1例胰管結石伴酒精性肝硬變，門靜脈高壓癥患者術后第23 d死于肝、腎功能衰竭。25例行中西醫結合治療，17例痊愈，8例好轉出院。另7例主動放棄治療。
結論 B超是胰管結石的首選檢查方法，MRCP對其診斷和治療有指導意義；胰管結石伴有嚴重的臨床癥狀或疑伴胰腺癌時，手術是其最佳選擇。

Citation： 李建水,張肇達,唐勇,何滿西,蔣力生,胡偉明,雷俊陽,嚴德輝. Clinical Analysis of Pancreatolithiasis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2006, 13(4): 456-458. doi: Copy

1.	呂云福主編. 現代胰腺外科學 [M]. 第1版. 北京：人民軍醫出版社, 2003∶ 245~252.
2.	Ammann RW, Muench R, Otto R, et al. Evolution and regression of pancreatic calcification in chronic pancreatitis. A prospective longterm study of 107 patients [Ｊ]. Gastroenterology, 1988; 95(4)∶ 1018.
3.	Takayama M, Hamano H, Ochi Y, et al. Recurrent attacks of autoimmune pancreatitis result in pancreatic stone formation [Ｊ]. Am J Gastroenterol, 2004; 99(5)∶ 932.
4.	Inui K, Tazuma S, Yamaguchi T, et al. Treatment of pancreatic stones with extracorporeal shock wave lithotripsy: results of a multicenter survey [Ｊ]. Pancreas, 2005; 30(1)∶ 26.
5.	趙向前，馮玉泉，周寧新，等. 胰管結石的診斷和治療 [Ｊ]. 中華普通外科雜志， 2002; 17(12)∶ 747.
6.	Miyachi A, Kikuyama M, Matsubayashi Y, et al. Successful treatment of pancreaticopleural fistula by nasopancreatic drainage and endoscopic removal of pancreatic duct calculi: a case report [Ｊ]. Gastrointest Endosc， 2004; 59(3)∶ 454.
7.	Fulcher AS, Turner MA, Yelon JA, et al. Magnetic resonance cholangiopancreatography (MRCP) in the assessment of pancreatic duct trauma and its sequelae: preliminary findings [Ｊ]. J Trauma, 2000; 48(6)∶ 1001.
8.	Jackson WD. Pancreatitis： etiology, diagnosis and management [Ｊ]. Curr Opin Pediatr, 2001; 13(5)∶ 447.
9.	Prasad SR, Sahani D, Saini S. Clinical applications of magnetic resonance cholangiopancreatography [Ｊ]. J Clin Gastroenterol, 2001; 33(5)∶ 362.
10.	Takahara Y， IchijyoK， TooyamaN, et al. Breathhold MRCP with a longechotrainfast spinecho sequence and a surface coil in chroniic pancreatitis [Ｊ]. Radiology, 1994; 192(1)∶ 73.
11.	Barish MA, Sato JA. MRCP: techniques and clinical applications [Ｊ]. AJR Am J Roentgenol, 1997; 169(10)∶ 1295.
12.	Hirai T, Goto H, Hirooka Y, et al. Pilot study of pancreatoscopic lithotripsy using a 5fr instrument: selected patients may benefit [Ｊ]. Endoscopy， 2004; 36(3)∶ 212.
13.	Sells H, Moretti KL, Leong WS, et al. Use of extracorporeal shockwave lithotripsy to treat a pancreatic duct calculus [Ｊ]. ANZ J Surg, 2004; 74(1-2)∶ 84.

1. 呂云福主編. 現代胰腺外科學 [M]. 第1版. 北京：人民軍醫出版社, 2003∶ 245~252.
2. Ammann RW, Muench R, Otto R, et al. Evolution and regression of pancreatic calcification in chronic pancreatitis. A prospective longterm study of 107 patients [Ｊ]. Gastroenterology, 1988; 95(4)∶ 1018.
3. Takayama M, Hamano H, Ochi Y, et al. Recurrent attacks of autoimmune pancreatitis result in pancreatic stone formation [Ｊ]. Am J Gastroenterol, 2004; 99(5)∶ 932.
4. Inui K, Tazuma S, Yamaguchi T, et al. Treatment of pancreatic stones with extracorporeal shock wave lithotripsy: results of a multicenter survey [Ｊ]. Pancreas, 2005; 30(1)∶ 26.
5. 趙向前，馮玉泉，周寧新，等. 胰管結石的診斷和治療 [Ｊ]. 中華普通外科雜志， 2002; 17(12)∶ 747.
6. Miyachi A, Kikuyama M, Matsubayashi Y, et al. Successful treatment of pancreaticopleural fistula by nasopancreatic drainage and endoscopic removal of pancreatic duct calculi: a case report [Ｊ]. Gastrointest Endosc， 2004; 59(3)∶ 454.
7. Fulcher AS, Turner MA, Yelon JA, et al. Magnetic resonance cholangiopancreatography (MRCP) in the assessment of pancreatic duct trauma and its sequelae: preliminary findings [Ｊ]. J Trauma, 2000; 48(6)∶ 1001.
8. Jackson WD. Pancreatitis： etiology, diagnosis and management [Ｊ]. Curr Opin Pediatr, 2001; 13(5)∶ 447.
9. Prasad SR, Sahani D, Saini S. Clinical applications of magnetic resonance cholangiopancreatography [Ｊ]. J Clin Gastroenterol, 2001; 33(5)∶ 362.
10. Takahara Y， IchijyoK， TooyamaN, et al. Breathhold MRCP with a longechotrainfast spinecho sequence and a surface coil in chroniic pancreatitis [Ｊ]. Radiology, 1994; 192(1)∶ 73.
11. Barish MA, Sato JA. MRCP: techniques and clinical applications [Ｊ]. AJR Am J Roentgenol, 1997; 169(10)∶ 1295.
12. Hirai T, Goto H, Hirooka Y, et al. Pilot study of pancreatoscopic lithotripsy using a 5fr instrument: selected patients may benefit [Ｊ]. Endoscopy， 2004; 36(3)∶ 212.
13. Sells H, Moretti KL, Leong WS, et al. Use of extracorporeal shockwave lithotripsy to treat a pancreatic duct calculus [Ｊ]. ANZ J Surg, 2004; 74(1-2)∶ 84.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical Analysis of Pancreatolithiasis

Abstract Full text Figures/Tables Video References Cited by

Format

Content