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1、宁夏医学杂志2003年1月第25卷第1期 NingxiaMedJ,Jan.2003,Vol25,No.1·11·文章编号:1001-5949(2003)01-0011-02·论 著·胰管结石诊治方法的探讨122侯文林,马宽生,嵇 武[摘要] 目的 探讨胰管结石症的诊断、治疗的方法和措施。方法 对1980-2001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Rou
2、x-en-Y吻合术22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-Y吻合术是治疗胰管结石的首要术式。[关键词]胰腺管;结石;诊断;外科手术[中图分类号]R657.5[文献标识码]ADiagnosisandtreatmentforpancreaticductstoneHOUWe
3、n-lin,etal.(Theinstituteofhepatobiliarysurgeryinsouthwesthospital,thethirdmilitarymedicaluniversity,Chongqing,400038)[Abstract]ObjectivesToexplorethemethodsofdiagnosisandtreatmentforpancreaticductstone.MethodsExperienceofdiagnosisandtreatmentforpancreaticductstonein39patientsfo
4、rm1980'supto2001'swereretrospectivelyanalyzedbyus.ResultsThemainsymptomsofthediseasearepaininmidsectionalongwithdiarrhea,thinandsomesymptomsofdiabetes,cauaedbydysfunc2tionofinsideanoutsidesecretionofpancreas.ThediagnosisareconfirmedbythemethodscombinedwithB-typeultrasonic,CTorE
5、RCP.31caseswereoperated,22withsplittingthepancreaticductandfetchingstoneandpancreaticojejunostomy,ofwhich,5patientscarryingwithbileductexplorationanddrainagewithTtudb;3patientswithcholangiojejunostomy;2caseswithlocalexcisingofheadofpancreas;3caseswithpancreatoduodenctomy;3patie
6、ntswithresectionofbodyandtrailofpancreas.Theoperativeeffectsaresatis2factory.ConclusionsThediagnosisofthediseaseisconfirmedbythemethodscombinedwithB-typeultrasonic,CTorERCP,butthefirstchoicstchoiceisB-typeultrasonic.Splittingthepancteaticductandfetchingstone,pancteatojejunostom
7、yistheoperationofthefirstchoice.[Keywords]Pancreaticduct;Calculi;Diagnosis;Surgery,Operative 胰管结石是一种少见的胰腺疾病。西南医院自规则钙化影;行B超检查35例,阳性32例,显示胰1980-2001年间共收治胰管结石39例,总结如下。管扩张和胰管结石,其中胰腺包块7例,胰腺假性囊1 资料和方法肿5例;CT检查29例,示胰管扩张及胰管结石291.1 一般资料:本组39例,男27例,女12例,年龄例,其中有胰腺不均匀增大、占位8例,胰腺假性囊18-75岁,平均
8、45.6岁。病程1月-10年,平均4.肿5例;ERCP检查插管成功16例,胰管显影13例,9年。临床表现:有
