胰腺分裂。

S Varshney, C D Johnson
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引用次数: 10

摘要

内镜逆行胰胆管造影(ERCP)是诊断性的。同样,分泌素刺激超声检查可以积极预测小乳头治疗的结果。计算机断层扫描仅有助于发现并发症。磁共振胰胆管造影(MRCP)是一种新型的无创诊断工具。它是准确的,可能取代ERCP诊断。临床上,有症状的PD患者可分为五组:1组,症状较轻的患者;2组:复发性急性胰腺炎或无其他原因的上腹痛患者;第三组为慢性胰腺炎患者;第四组为慢性胰腺疼痛患者;第五组,有其他并发症的患者。第1组应单独用药物治疗。小乳头手术或内镜治疗的效果在第2组为良好(75-90%),第3组为中等(40-60%),第4组较差(20-40%)。少数患者需要其他形式的胰腺手术,如Puestow手术、Beger手术或远端胰腺切除术。通过对患者和治疗方法的精心选择,可以获得良好的治疗反应。胰腺分裂(PD)是胰腺最常见的先天性异常,发病率高达10%。PD患者出现的症状或并发症并不常见(占PD患者的5%)。PD似乎不太可能单独引起阻塞性胰腺炎,另一个因素的存在,如小乳头功能不全,可能是这种相对常见的异常发生并发症的必要条件。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pancreas divisum.

Endoscopic retrograde cholangiopancreatography (ERCP) is diagnostic. Similarly, secretin stimulated ultrasonography may positively predict the outcome of minor papilla therapy. Computed tomography is only helpful for the detection of complications. Magnetic resonance cholangiopancreatography (MRCP) is a new noninvasive diagnostic tool in development. It is accurate and might replace ERCP for diagnosis. Clinically, symptomatic patients with PD may be divided into five groups: group 1, those with minimal symptoms; group 2, those with recurrent acute pancreatitis or upper abdominal pain with no other cause; group 3, those with chronic pancreatitis; group 4, those with chronic pancreatic pain; and group 5, those with other complications. Group 1 should be treated with medical therapy alone. The response to surgical or endoscopic therapy of the minor papilla is good in group 2 (75-90%), moderate in group 3 (40-60%), and poor in group 4 (20-40%). A few patients require other forms of pancreatic surgery, such as Puestow's operation, Beger's operation, or distal pancreatectomy. With careful selection of patient and therapy, good response to the therapy can be achieved. Pancreas divisum (PD) is the most common congenital anomaly of the pancreas, with an incidence of up to 10%. Symptoms or complications developing in individuals with PD are uncommon (5% of individuals with PD). It seems unlikely that PD alone could cause obstructive pancreatitis and the presence of another factor, such as minor papilla insufficiency, is probably required for this relatively common anomaly to develop complications.

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