CAJ | 학술논문

目的探讨胰管结石的诊断和综合治疗。方法回顾性分析收治的21例胰管结石患者的临床资料。21例术前均得以确诊，其中B超确诊率为90.5％( 19/21)，CT扫描因不能区分结石与钙化，确诊率为66.7％（14/21），MRI确诊率为55.6％(5/9)。17例手术治疗，4例内镜治疗。结果术后1例出现胰漏带管出院，1例内镜治疗后发生急性胰腺炎，经保守治疗后痊愈，术后10～21d出院。19例获得随访，随访时间4～72个月，疼痛症状明显缓解，无结石复发、吻合口狭窄和恶变等并发症，6例有轻度脂肪泻。结论对于胰管结石，B超、CT基本能够明确诊断，且B超确诊率高于CT，胰管切开取石+胰管空肠Roux-en-Y吻合术是外科治疗胰管结石的主要术式，内镜已经成为处理胰管结石的一种方法。
목적탐토이관결석적진단화종합치료。방법회고성분석수치적21례이관결석환자적림상자료。21례술전균득이학진，기중B초학진솔위90.5％( 19/21)，CT소묘인불능구분결석여개화，학진솔위66.7％（14/21），MRI학진솔위55.6％(5/9)。17례수술치료，4례내경치료。결과술후1례출현이루대관출원，1례내경치료후발생급성이선염，경보수치료후전유，술후10～21d출원。19례획득수방，수방시간4～72개월，동통증상명현완해，무결석복발、문합구협착화악변등병발증，6례유경도지방사。결론대우이관결석，B초、CT기본능구명학진단，차B초학진솔고우CT，이관절개취석+이관공장Roux-en-Y문합술시외과치료이관결석적주요술식，내경이경성위처리이관결석적일충방법。
Objective To explore diagnosis and surgical treatment of pancreatic duct stone.Methods Clinical data of 21 patients with pancreatic duct stone was analyzed retrospectively. All patients were diagnosed definitely by B-ultrasonography,CT and MRI, the positive rates were 90.5％( 19/21 ),66.7％(14/21) and 55.6％ (5/9) respectively, 15 cases did transpancreatic duct lithotomy and pancreatico-intestinal anastomosis, 1 case excised the tail of pancreas simultaneously, 1 case did pancreaticoduodenectomy, 4 cases treated by endoscopy. Results All operations succeeded, 1 case occurred with pancreatic leakage after a small amount of discharge tube, 1 case appeared acute pancreatitis after endoscopic treatment,who was discharged after conservative treatment. Following up 19 cases from 4 to 72 months, the symptom was released, no stone relapsed,6 cases with mild catarrhal dysentry. Conclusion B-ultrasonography, CT can basically make definite diagnosis for pancreatic duct stone, and B-ultrasonography has higher rate of diagnosis, transpancreatic duct lithotomy and pancreatico-intestinal anastomosis are the main surgical treatments, endoscopy is the method to treat pancreatic duct stone.