胰管结石28例的临床诊断与治疗分析

目的探讨胰管结石患者的诊断及外科治疗方法。方法对28例胰管结石的临床资料进行回顾性分析。全组采用影像学检查方法（B超、腹部X平片、CT、内镜逆行胰胆管造影、磁共振胰胆管造影）确诊。24例行胰管切开取石、胰管空肠侧侧Roux-en-Y吻合术,3例行胰体尾切除、胰断端套入空肠端Roux-en-Y吻合术,胰十二指肠切除术1例。结果全组无手术并发症,术后28例随访1个月～5年,25例术前有上腹疼痛症状者,术后20例腹痛消失,5例腹痛减轻;10例合并糖尿病者8例血糖恢复正常;5例合并脂肪泻者3例脂肪泻消失,2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吻合术是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 treatment of pancreatic duct stones.Methods The clinical data of 28 cases of pancreatic duct stones who underwent operation were analyzed retrospectively.Results The diagnosis of all cases was confirmed by imaging examinations such as B ultrasonography、 abdominal X-ray film,CT,ERCP or MRCP.The operative methods were pancreatolithotomy with Roux-en-Y side-to-side pancreaticojejunostomy in 24 cases,distal pancreatectomy with pancreatojejunostomy in 3 cases and pancreatoduodenectomy in 1 cases.No operative complication was found.28 cases were followed for 1 month to 5 years after operation.Among 25 cases with upper abdominal pain before operation,the abdominal pain disppeared in 20 cases and was alleviated in 5 cases postoperatively.Among 10 cases with diabetes mellitus before opreation,blood glucose returned to normal in 8 cases postoperatively.Among 5 cases with steatorrhea before operation,the steatorrhea disappeared in 3 cases and was alleviated in 1 cases postopereatively.Conclusion 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.