胰管结石性慢性胰腺炎的临床特点与外科治疗

目的探讨胰管结石性慢性胰腺炎的临床特点及外科术式选择与疗效。方法回顾性分析我院外科1983年1月至2006年12月间收治并手术治疗的31例胰管结石性慢性胰腺炎患者的临床资料、手术方式和疗效。结果胰管结石性慢性胰腺炎患者多见于酗酒所致的酒精性胰腺炎,腹痛为最突出临床表现,胰腺内外分泌功能减退较为常见。B超及CT为最常用的检查手段,对胰管结石的诊断准确率分别达到96.8%（30/31）和100%（26/26）,患者多同时存在胰腺萎缩及钙化、胰管扩张等。31例患者共接受32例次手术,胰管取石＋括约肌成形术2例,胰尾空肠吻合3例,改良Puestow术13例,Whipple手术9例,Frey手术5例。手术效果满意。结论胰管结石性慢性胰腺炎临床表现复杂,病因以酒精性为主,腹部B超和CT检查多可明确诊断。手术治疗是缓解症状的主要治疗手段,外科治疗应采用个体化原则。

Clinical features and surgical treatments of chronic pancreatitis with pancreatic duct stones

Objective To evaluate the clinical features and outcome of surgical management of chronic pancreatitis with pancreatic duct stones.Methods The clinical data of 31 patients with chronic pancreatitis associated with pancreatic duct stones undergoing operation in our hospital from 1983 to 2006 were analyzed retrospectively.Results The most common cause of chronic pancreatitis with pancreatic duct stones was alcohol related pancreatitis.And abdominal pain was the most common clinical manifestation.Pancreatic functions also decreased in most patients.Bulfrasaund and CT scan could make the correct dignosis in 96.8%(30/31)and 100%(26/26)of the patients.And the major radiological features included atrophy of pancreas,pancreatic calcification and distention of pancreatic duct.The 31 patients received 32 surgical treatments which included 2 sphincteroplasty,3 distal pancreas-jejunum anastomosis,13 modified puestow procedure,9 Whipple procedure,and 5 Frey procedure.The outcomes of surgical managements were satisfied.Conclusions The clinicopathologic characteristics of obstructive chronic pancreatitis are variable,and alcohol abuse is the most common cause.Bulfrasound and CT scan can diagnose most patients.The surgical management should be also different to differenf individuals.