肝胆胰外科杂志2011，Vol.23Issue(1)：15-17,3.
十二指肠乳头生理性过长致胆胰管梗阻病变的内镜诊断与治疗
Role of endoscope in diagnosis and treatment of the pancreatobiliary obstructive diseases induced by physiologically overlengthed papilla
王爱东 1陈志红 2张法标 1杨健 1张财明 1吕尚东 1龚彪 3方哲平1
作者信息
- 1. 浙江省台州医院肝胆外科,浙江,台州,317000
- 2. 浙江省台州医院服务中心,浙江,台州,317000
- 3. 上海交通大学附属瑞金医院,消化科,上海,200025
- 折叠
摘要
Abstract
Objective To report the clinical characters of physiologically overlengthed papilla resulted in the pancreatobiliary ducts obstruction, and the value of endoscope in the diagnosis and treatment on it. Methods From Feb 2004 to June 2010, 2150 ERCPs were done in our department, among which 10 cases were special and different in diagnosis between clinical and ERCP. The clinical data of the 10 cases, including three recurrent pancreatitis, four ampullar occupied and three enlarged CBD or suspected CBD stone were analyzed retrospectively. The papilla lengths of this 10 cases and another 40 cases of control group without pancreatobiliary diseases were measured under endoscope. Results During ERCP, nothing but CBD dilation was found in 7 cases and overlengthed papilla were found in all of the 10 cases. The diameter of CBD was 11～16 mm (mean 12.2+2.5 mm). The papilla length of the 10 cases was 16～29 mm (mean 19.7+3.9 mm), and that of the control group was 3～15 mm (mean 9.5+2.6 mm, t=9.78, P＜0.001). In the 10 eases, clinical symptoms were disappeared after EST or ENBD, with the complications of one bleeding and two hyperamylase. Two biopsy and one brushing were done for pathology, no tumor was found. After 6～37 months follow-up, there was no recurrence. Conclusion Physiologically overlengthed papilla is a rare factor which may cause this type of pancreatobiliary obstruction, it must to be considered in some idiopathic panereatitis, recurrent pancreatitis and cholangiopancreatic obstructive cases, ERCP is an effective method both in diagnosis and treatment.关键词
内窥镜/十二指肠乳头/内镜逆行胰胆管造影术/内镜乳头括约肌切开术Key words
endoscope/ papilla/ endoscopic retrograde cholangiopancreatography (ERCP)/ endoscopic sphincterotomy (EST)分类
医药卫生引用本文复制引用
王爱东,陈志红,张法标,杨健,张财明,吕尚东,龚彪,方哲平..十二指肠乳头生理性过长致胆胰管梗阻病变的内镜诊断与治疗[J].肝胆胰外科杂志,2011,23(1):15-17,3.
