胰管结石的诊断及处理

目的探讨胰管绱石的诊断及外科处理方法。方法对1985—2005年于术治疗的24例胰管结石的临床资料进行回顾性分析。结果全组均采用影像学检查方法（B超，腹部X线平片，CT，内镜逆行胰胆管造影．磁共振胰胆管造影）确诊。行胰切开取石、胰管空肠侧侧Roux-en-Y吻合术19例，胰体尾切除、胰断端套入空肠端Roux-en-Y吻合术4例，胰十二指肠切作术1例。无手术并发症。术后24例随访2个月至4年。23例术前有上腹痛症状者，术后19例腹痛消失，4例腹痛减轻。8例合并糖尿病者，4例血糖恢复正常。5例合并脂肪泻者，2例脂肪泻消失，1例减轻。结论影像学检查是确诊胰管结石的主要方法。胰管切开取石、胰管空肠侧侧Roux-en-Y吻合术为治疗胰管结石的主要术式。

The diagnosis and treatment of pancreatic duct stones

Objective To explore the diagnosis and surgical treatment of pancreatic duct stones. Methods The clinical data of 24 cases of pancreatic duct stones who underwent operation from 1985 to 2005 were analyzed retrospectively. Results The diagnosis of all cases was confirmed by imaging examinations such as B ultrasonography, abdominal X-ray film, CT, endoscopic retrograde cholangiopancreatography or magnetic resonance cholangiopancreatography The operative methods were pancreatolithotomy with Roux-en-Y side-to-side pancreaticojejunostomy in 19 cases, distal pancreatectomy with pancreatojejunostomy in 4 cases and pancreatoduodenectomy in I case. No operative complication was found. Tweenty- four cases were followed for 2 months to 4 years after operation. Among 23 cases with upper abdominal pain before operation, the abdominal pain disappeared in 19 cases and was alleviated in 4 cases postoperatively. Among 8 cases with diabetes mellitus before operation , blood glucose returned to normal in 4 cases postoperatively. Among 5 cases with steatorrhea before operation, the steatorrhea disappeared in 2 cases and was alleviated in 1 case postoperatively. Conclusions Imaging examinations are the main methods for diagnosis of pancreatic duct stones. The main operative method is pancreatolithotomy with Roux-en-y side-to-side pancreaticojejunostomy.