壶腹隔膜的形态及其生理意义

目的：探讨胆石性胰腺炎的产生与胆、胰合流部的解剖学关系。方法：对２９例新鲜成人尸体标本进行了实验及解剖学观察。结果：７９％（２３例）的胰管有防止胆胰返流的功能，其开口处和胆管之间菲薄的壶腹隔膜有“活瓣”样作用，可能是防止胆胰返流的重要结构。该活瓣构造不全者占１０％（３例）。胆管和胰管的汇合角度是造成壶腹隔膜构造变异的原因。结论：胆胰管汇合角度过大造成壶腹隔膜短而厚，“活瓣”功能丧失，使胆胰返流容易发生。这可能是共同通道过长者易发生胆石性胰腺炎的根本原因。

Morphological characters of the ampulla septum and its clinical significance

Abstract Objective: To explore the relationship of acute gallstone pancreatitis (AGP) and the anatomic character of pancreaticobiliary conjunction.Methods:Experimental test and anatomical observeation of the pancreaticobiliary conjunction were carried out on 29 fresh human pancreaticoduodenal specimens. Results:Seventy nine percent (23 cases) of the pancreatic ducts had the ability of anti bilicopancreatic reflux.The "valve like" ampulla septum at the pancreaticobiliary conjunction seemed to be the important physical structure.While aplasia ampulla septum could be found in 10% of them (3 cases).This aplasia may result from the variation in the conjunction angles.Conclusions: Long common channel might result in a larger conjunction angle, a short thick ampulla septum and the lack of anti reflux capacity.Therefore, the bile juice would regurgitate into the pancreatic duct easily.This might be the primary reason for those of longer common channel were more susceptible to AGP.