肝胰壶腹黏膜瓣的解剖学研究及临床意义

目的：研究正常胎儿、婴儿、成人胰胆管末端的生长发育和结构特点与功能的关系。方法：选62例无消化道畸形胎20wk至生后1mo内的婴儿尺体，10例成人的肝胆胰十二指肠段。在手术显微镜下解剖观察肝胰（Vater）壶腹内部结构。通过石蜡包埋切片HE染色，观察肝胰（Vater)壶腹的内部结构。结果：Vater壶腹管壁增厚，由环行肌和黏腺组成，管脸突然变窄，管腔内充满黏膜瓣，胎儿为锯齿状，矢形突起，彼此重叠，成人为环形叶状瓣，近乳头部明显，胰胆管末端为锯齿状瓣，由结缔组织和丰富毛细血管丛组成。结论：肝胰（Vater）壶腹的结构特点，有抗反流的作用，其随生长发育功能不断完善。

AN ANATOMICAL STUDY OF THE VATER AMPULLA AND CLINICAL SIGNIFICANCE

Objective:To study development and anatomic character and function in the normal fetus,infants and adult.Methods:Common bile duct and the choledochoduodenal junction were dissected and observed on the 62 specimens showing no deformity of the digestive system from 20 to 40 week fetus,infants and 10 subjects from adult.Each specimen comprised in one piece the whole duodenum,pancreas and the common bile duct.Results:This level of duct wall was thickened by an increase in its content of connective tissue and mucous glands.The level corresponds with the beginning of the thickened segment which can detected macroscopically this sudden thickening in the duct wall as an abrupt narrowing of the lumen of the duct.Microscopical evidence was presented which show that the lumen of the intraduodenal portion of common bile duct is almost completely filled by folds of a highly vascularized mucosa.Conclusion:The character of Vater ampulla have antireflux capacity.It was getting perfect with the development of the fetus.