CAJ | 학술논문

目的：探讨胰管结石的分型及手术方法。方法对8例行手术治疗的胰管结石合并慢性胰腺炎或胰腺癌患者病历资料进行分析。8例患者术前均行腹部B超、上腹部CT平扫＋增强或磁共振胆胰管水成像（MRCP）检查以明确诊断。其中Ⅰ型2例，采用胰头十二指肠切除术；Ⅱ型1例，采用胰尾切除＋脾切除＋胰管空肠吻合术；Ⅲ型5例，采用胰管切开取石并胰管空肠吻合术。结果8例均成功手术，1例术后并发胰漏，经非手术治疗后好转；5例糖尿病患者术后3例血糖恢复正常。结论胰管结石发病率虽然不高，但常合并胰腺炎、糖尿病甚至胰腺癌，后果严重，依胰管结石部位分型并选择合理的手术方法极为重要。
목적：탐토이관결석적분형급수술방법。방법대8례행수술치료적이관결석합병만성이선염혹이선암환자병력자료진행분석。8례환자술전균행복부B초、상복부CT평소＋증강혹자공진담이관수성상（MRCP）검사이명학진단。기중Ⅰ형2례，채용이두십이지장절제술；Ⅱ형1례，채용이미절제＋비절제＋이관공장문합술；Ⅲ형5례，채용이관절개취석병이관공장문합술。결과8례균성공수술，1례술후병발이루，경비수술치료후호전；5례당뇨병환자술후3례혈당회복정상。결론이관결석발병솔수연불고，단상합병이선염、당뇨병심지이선암，후과엄중，의이관결석부위분형병선택합리적수술방법겁위중요。
Objective To discuss the classification and surgical treatment of pancreatic duct stone.Methods The data of 8 cases of pancreatic duct stone combined with chronic pancreatitis or pan-creatic cancer were reviewed.All patients'diagnoses were confirmed by abdominal type-B ultrasound,plain and contrast enhanced CT scan of the upper abdomen and magnetic resonance cholangio paneretography (MRCP).Among them,two type I cases underwent pancreatoduodenectomy,one type II case underwent pancreatic cauda resection,splenectomy and pancreaticojejunostomy,and five type III cases received pan-creatic duct lithotomy and pancreaticojejunostomy.Results All surgeries were successfully performed. One case is complicated with pancreatic leakage after operation and recovered after non-surgical treatment. Three out of five cases with diabetes recovered with normal blood sugar.Conclusion Although the inci-dence of pancreatic duct stone is low,it's commonly complicated with pancreatitis,diabetes,or even pancre-atic cancer,which results in serious consequences.Based on the location of stones,classification is very im-portant in the selection of appropriate procedures.