胆总管囊肿合并胰腺病变及其术后变化

目的 观察先天性胆总管囊肿合并胰腺病变的发生情况，探讨其术后变化规律。方法 对1988年10月至2001年4月间手术治疗的83例先天性胆总管囊肿进行回顾性分析，观察胆总管囊肿切除术前后尿淀粉酶、B超检查胰腺病变及术中所见情况。结果 术前尿淀粉酶升高31例(共检查56例，占55％)，B超发现胰腺病变13例，占44例胰腺B超的29％，术中胰腺改变7例。术后住院期间尿淀粉酶恢复正常20例，占65％，13例术前B超检查异常和7例术中可见胰腺病变共15例，术后3月B超复查均有不同程度好转，6例仍可见明显胰腺病理变化。结论 胆总管囊肿合并胰腺病变发生率高，早期行胆总管囊肿切除术有利于胰腺病变的恢复。

Choledochal Cyst Complicated with Pancreatic Pathologic Changes and Outcome Following Operation

Objective To observe the developmental situation of phathologic changes of pan creas in congenital choledochal cysts patients complicated with pancreatic disease, and to explore its change regulation following operation. Methods From Oct. 1988 to Apr. 2001, 83 in-patients with choledochal cyst, who had undergone cholecystectomy, were analyzed, retrospectively; their urinary amylase activities were determined, B-ultrasonography was carried out in operative period. Results Of the 56 cases, 31 cases(55%) had increased urinary amylase activity, B-ultrasonography examination of 44 cases were shown that 13 cases (29%) had pathologic changes of pancreas, 7 cases of them had obvious pathologic changes of pancreas. B-ultrasonographic repeatitive examina tion showed that different degrees recovery 3 months following cholecystectomy, but remarkable pathologic changes of pancreas still existed in 6 cases. Conclusions The morbidity of choledochal cyst complicated with pathologic change of pancreas is much high, cholecystectomy is a useful therapy to reverse the pathologic changes of pancrease.