儿童胆道扩张症与胰胆管合流异常的相关性

目的 通过回顾性分析先天性胆道扩张症(CBD)临床病例资料,比较合并胰胆管合流异常(PBM)与无合流异常病例的临床特征之间的差异,探讨PBM以及共同管长度与CBD的发病、临床症状、相关实验室检查结果的相关性,为CBD的发病机理和诊断治疗提供新的理论依据.方法 回顾性总结2017年1月至2019年12月首都医科大学附属北...

Correlation of biliary dilatation and pancreatiobiliary maljunction in children

Objective To put forward new theoretical basis for pathogenic mechanism, diagnosis and treatment of congenital biliary dilatation (CBD) by retrospective clinical study comparing the differences between pancreatiobiliary maljunction (PBM) cases and non-PBM cases, in which the correlation of CBD and PBM was investigated in terms of symptoms, sign, lab test results and the lengths of common channel. MethodsClinical data of CBD patients admitted in Department of General Surgery, Beijing Children’s Hospital from Jan. 2017 to Dec. 2019 were retrospectively analyzed. The enrolled 83 CBD patients were divided into two groups (PBM group, with length of common channel ≥5 mm, n=47; non-PBM group with length of common channel < 5 mm, n=36) according to the MRCP results. The research data included age of ailment, gender, symptoms, liver functions, BIL, AMY, common channel length, pancreatic stone and size of congenital choledochal cyst. Nonparametric test and χ2 -test were used for statistical analysis. Results Clinical studies showed that there were no significant differences between the two groups in terms of fever, jaundice, white stool or bile duct stones (P>0.05), while abdominal pain was prevalent in PBM group (P<0.05); lab results showed no significant differences in AST, ALT, TBIL, DBIL or IBIL between two groups (P>0.05), only AMY in PBM group appeared to be higher (P<0.05). The PBM group showed 32 cases (38.6%) of choledochal cyst and 15 cases (18.1%) of shuttle shape, while the non-PBM group showed 26 cases (31.3%) of choledochal cyst and 10 cases (12.0%) of shuttle shape, with no significant difference between two groups (P>0.05). However, the size of choledochal cyst appeared to be significantly smaller in the PBM group (P=0.02). Conclusion This research reveals that CBD associated with PBM will lead to early severe abdominal pain and higher AMY, which is easily to be diagnosed at an early stage, accounting for the smaller size of the cyst in PBM. The length of common channel shows no significant correlation with clinical test on liver functions, BIL, or AMY levels in CBD. Therefore, the length of common channel alone might not be used for judging the severity of CBD.