CAJ | 학술논문

目的探讨胆源性胰腺炎(ABP)和胰胆管合流异常(anomalous pancreaticobiliary ductalunion,APBDU)的关系.方法选择ABP患者131例,入院后抽取静脉血检查总胆红素(TB)、ALT、AST、ALP,γ-GT.先行非手术治疗,待病情稳定后复查上述指标,然后择期手术,并行术中胆道造影,观察胰胆管合流情况.结果 131例ABP患者中发现APBDU 27例,占20.6%.其中胆总管汇入胰管(Ⅰ型)8例,占29.6%,胰管汇入胆总管(Ⅱ型)16例,占59.3%,复杂型(Ⅲ型)3例,占11.1%.经非手术治疗后,TB、ALT、AST、ALP、γ-GT含量均较入院时明显降低(P＜0.05),其中APBDU患者的ALT为(71.81±23.19)U/L,AST为(47.85±27.87)U/L,γ-GT为(52.86±31.49)U/L,仍明显高于无APBDU患者的(51.96±15.40)U/L、(40.77±16.58)U/L和(34.86±26.47)U/L(P＜0.05).结论胰胆管合流异常足导致ABP的重要原因之一.
목적 탐토담원성이선염(ABP)화이담관합류이상(anomalous pancreaticobiliary ductalunion,APBDU)적관계.방법 선택ABP환자131례,입원후추취정맥혈검사총담홍소(TB)、ALT、AST、ALP,γ-GT.선행비수술치료,대병정은정후복사상술지표,연후택기수술,병행술중담도조영,관찰이담관합류정황.결과 131례ABP환자중발현APBDU 27례,점20.6%.기중담총관회입이관(Ⅰ형)8례,점29.6%,이관회입담총관(Ⅱ형)16례,점59.3%,복잡형(Ⅲ형)3례,점11.1%.경비수술치료후,TB、ALT、AST、ALP、γ-GT함량균교입원시명현강저(P＜0.05),기중APBDU환자적ALT위(71.81±23.19)U/L,AST위(47.85±27.87)U/L,γ-GT위(52.86±31.49)U/L,잉명현고우무APBDU환자적(51.96±15.40)U/L、(40.77±16.58)U/L화(34.86±26.47)U/L(P＜0.05).결론 이담관합류이상족도치ABP적중요원인지일.
Objective To investigate the relationship between acute biliary pancreatitis (ABP) and anomalous pancreaticobiliary duetal union (APBDU). Methods 131 patients with ABP were enrolled to test the serum total bilirubin (TB), alanine amintransferase (ALT), aspartate amintransferase (AST), alkaline phosphates (ALP), γ-glutamyl transferase (γ-GT). All the patients received medical treatment, and then these tests were performed again. Thereafter, all the patients underwent selective surgery and intra-operative cholangiography was performed to observe the pancreaticobiliary duetal union. Results 27 patients (20.6%) with APBDU were found in 131 patients. Among them, 8 cases (29.6%) was B-P subtype (TypeⅠ), 16 cases (59.3%) was P-B subtype (TypeⅡ) , and the remaining 3 cases was mixed subtype (TypeⅢ). A significant decrease of ALT, AST, ALP, γ-GT after non-surgical treatment in both group of APBDU and NAPBDU was noted (P＜0.05). The serum levels of ALT, AST,γ-GT in APBDU patients were (71.81± 23.19) U/L, (47.85±27.87) U/L, (52.86±31.49) U/L, respectively; and in NAPBDU patients were (51.96±15.40) U/L, (40.77±16.58) U/L, (34.86±26.47) U/L. The difference was statistically significant (P＜0.05). Condusions APBDU is an important etiology of ABP.