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

摘要:

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。

Abstract:

【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.