Oddi括约肌狭窄的诊治体会

目的 探讨Oddi括约肌狭窄的诊断及治疗方法.方法 对1990年至2005年间45例Oddi括约肌狭窄的临床资料进行回顾性分析.结果 45例中有27例术前进行过磁共振胆胰管造影（MRCP）检查,8例获得诊断;25例切开十二指肠行括约肌成形术,术后病理证实为Oddi括约肌狭窄;20例经ERCP确诊,并行内镜括约肌切开术.因MRCP的广泛使用,2000年后Oddi括约肌狭窄的术前诊断率明显提高,2000年前为2/27,2000年后为6/18（χ2=4.79,P＜0.05）.内镜括约肌切开术术后胰腺炎发生率为3/20,经十二指肠Oddi括约肌成形术术后胰腺炎发生率为4/25（χ2=0.01,P＞0.9）.结论 MRCP是诊断Oddi括约肌狭窄理想的非损伤性检查;内镜括约肌切开术是治疗Oddi括约肌狭窄的有效方法.

Experience in the diagnosis and treatment of Oddi sphincter stenosis

Objective To investigate the diagnosis and treatment of Oddi sphincter stenosis. Methods Clinical data of 45 patients of Oddi sphincter stenosis were analyzed retrospectively. Results Of the 45 patients, 27 underwent preoperative MRCP with definite diagnosis in 8 cases. Twenty-five underwent transduodenal sphincteroplasty (TSP) , with the diagnosis proved by pathology. Twenty patients received ERCP and underwent endoscopic sphincterotomy (EST). With MRCP being used more frequently preoperative definite diagnosis rate increased from 2/27 before the year 2000 to 6/18 after the year 2000, X2= 4.79,P < 0. 05, the post EST pancreatitis rate was 3/20, post TSP was 4/25 (x2 =0.01, P>0.9). Conclusions MRCP is effective method for the diagnosis of Oddi sphincter stenosis. EST is an ideal method to cure Oddi sphincter stenosis.