胰胆管汇合异常的诊治进展

doi:10.16139/j.1007-9610.2020.06.018

摘要/Abstract

关键词: 胰胆管汇合异常, 磁共振胰胆管造影术, 内镜逆行胰胆管造影术, 内镜乳头括约肌切开术

中图分类号:

刘宇虹, 邓刚, 陈俊宗(综述), 汤地(审校). 胰胆管汇合异常的诊治进展[J]. 外科理论与实践, 2020, 25(06): 523-528.

LIU Luhong, DENG Gang, CHEN Junzong, TANG Di. Progress in diagnosis and treatment of pancreaticobiliary maljunction[J]. Journal of Surgery Concepts & Practice, 2020, 25(06): 523-528.

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参考文献 34

[1]	Ragot E, Mabrut JY, Ouaïssi M, et al. Pancreaticobiliary maljunctions in European patients with bile duct cysts: results of the multicenter study of the French Surgical Association (AFC)[J]. World J Surg, 2017, 41(2):538-545. doi: 10.1007/s00268-016-3684-x URL
[2]	Ono A, Arizono S, Isoda H, et al. Imaging of pancreaticobiliary maljunction[J]. Radiographics, 2020, 40(2):378-392. doi: 10.1148/rg.2020190108 URL
[3]	Schoenwolf GC, Bleyl SB, Brauer PR, et al. Development of the gastrointestinal tract[M]// Schoenwolf GC, Bleyl SB, Brauer PR, et al. Larsen’s Human Embryology. 5th ed. Philadelphia: Churchill Livingstone/Elsevier, 2014:341-374.
[4]	Sherifi F, Bexheti S, Gashi Z, et al. Anatomic variations of pancreaticobiliary union[J]. Open Access Maced J Med Sci, 2018, 6(6):988-991. doi: 10.3889/oamjms.2018.196 pmid: 29983789
[5]	Yoshimoto K, Kamisawa T, Kikuyama M, et al. Classification of pancreaticobiliary maljunction and its clinical features in adults[J]. J Hepatobiliary Pancreat Sci, 2019, 26(12):541-547. doi: 10.1002/jhbp.691 URL
[6]	郭万亮. 儿童胰胆管合流异常临床实践专家共识[J]. 临床肝胆病杂志, 2019, 35(12):2712-2715.
[7]	Kamisawa T, Kuruma S, Chiba K. Congenital biliary dilatation and pancreaticobiliary maljunction[J]. Nihon Shokakibyo Gakkai Zasshi, 2016, 113(12):1991-1997.
[8]	Hamada Y, Ando H, Kamisawa T, et al. Diagnostic crite-ria for congenital biliary dilatation 2015[J]. J Hepatobiliary Pancreat Sci, 2016, 23(6):342-346. doi: 10.1002/jhbp.346 URL
[9]	Andriulli A, Loperfido S, Napolitano G, et al. Incidence rates of post-ERCP complications: a systematic survey of prospective studies[J]. Am J Gastroenterol, 2007, 102(8):1781-1788. doi: 10.1111/j.1572-0241.2007.01279.x pmid: 17509029
[10]	Patel S, Marshak J, Daum F, et al. The emerging role of endoscopic ultrasound for pancreaticobiliary diseases in the pediatric population[J]. World J Pediatr, 2017, 13(4):300-306. doi: 10.1007/s12519-017-0020-y URL
[11]	Soares KC, Goldstein SD, Ghaseb MA, et al. Pediatric choledochal cysts: diagnosis and current management[J]. Pediatr Surg Int, 2017, 33(6):637-650. doi: 10.1007/s00383-017-4083-6 pmid: 28364277
[12]	Saito T, Terui K, Mitsunaga T, et al. Significance of imaging modalities for preoperative evaluation of the pancreaticobiliary system in surgery for pediatric choledochal cyst[J]. J Hepatobiliary Pancreat Sci, 2016, 23(6):347-352. doi: 10.1002/jhbp.347 URL
[13]	Kamisawa T, Ando H, Suyama M, et al. Japanese clinical practice guidelines for pancreaticobiliary maljunction[J]. J Gastroenterol, 2012, 47(7):731-759. doi: 10.1007/s00535-012-0611-2 pmid: 22722902
[14]	Guo WL, Huang SG, Wang J, et al. Imaging findings in 75 pediatric patients with pancreaticobiliary maljunction: a retrospective case study[J]. Pediatr Surg Int, 2012, 28(10):983-988. pmid: 22892909
[15]	Itoh S, Fukushima H, Takada A, et al. Assessment of anomalous pancreaticobiliary ductal junction with high-resolution multiplanar reformatted images in MDCT[J]. Am J Roentgenol, 2006, 187(3):668-675. doi: 10.2214/AJR.05.0824 URL
[16]	Maguchi H, Osanai M, Katanuma A, et al. Imaging diagnosis for pancreaticobiliary maljunction[J]. Nihon Shoka-kibyo Gakkai Zasshi, 2014, 111(4):690-698.
[17]	朱呈瞻, 董蒨. 胰胆管合流异常症的诊断与处理[J]. 肝胆外科杂志, 2018, 26(5):391-393.
[18]	Urushihara N, Hamada Y, Kamisawa T, et al. Classification of pancreaticobiliary maljunction and clinical features in children[J]. J Hepatobiliary Pancreat Sci, 2017, 24(8):449-455. doi: 10.1002/jhbp.485 URL
[19]	Fukuzawa H, Urushihara N, Miyakoshi C, et al. Clinical features and risk factors of bile duct perforation associa-ted with pediatric congenital biliary dilatation[J]. Pediatr Surg Int, 2018, 34(10):1079-1086. doi: 10.1007/s00383-018-4321-6 pmid: 30076449
[20]	Morine Y, Shimada M, Takamatsu H, et al. Clinical features of pancreaticobiliary maljunction: update analysis of 2nd Japan-nationwide survey[J]. J Hepatobiliary Pancreat Sci, 2013, 20(5):472-480. doi: 10.1007/s00534-013-0606-2 URL
[21]	祁春春, 蔡小泥, 张诚, 等. 胰胆管合流异常并发急性胰腺炎的诊治策略并文献复习[J]. 中华肝胆外科杂志, 2018, 24(3):206-208.
[22]	Kamisawa T, Matsukawa M, Amemiya K, et al. Pancrea-titis associated with pancreaticobiliary maljunction[J]. Hepatogastroenterology, 2003, 50(53):1665-1668.
[23]	Tashiro S, Imaizumi T, Ohkawa H, et al. Pancreaticobiliary maljunction: retrospective and nationwide survey in Japan[J]. J Hepatobiliary Pancreat Surg, 2003, 10(5):345-351. doi: 10.1007/s00534-002-0741-7 URL
[24]	Yada K, Mori H, Ishibashi H, et al. Carcinogenesis of biliary tract in pancreaticobiliary maljunction[M]// Kamisawa T, Ando H, Kamisawa T, et al. Pancreaticobiliary Maljunction and Congenital Biliary Dilatation. Singapore Springer: Singapore, 2018:173-179.
[25]	Morine Y, Mori H, Utsunomiya T, et al. Epidemiology and clinical features of pancreaticobiliary maljunction[J]. Tando, 2011, 25(1):133-140.
[26]	杨玉龙. 胆胰汇合部疾病的临床思考和诊治策略[J]. 外科理论与实践, 2015, 20(2):102-107.
[27]	Kamisawa T, Kaneko K, Itoi T, et al. Pancreaticobiliary maljunction and congenital biliary dilatation[J]. Lancet Gastroenterol Hepatol, 2017, 2(8):610-618. doi: 10.1016/S2468-1253(17)30002-X URL
[28]	Aly MYF, Mori Y, Miyasaka Y, et al. Laparoscopic surgery for congenital biliary dilatation: a single-institution experience[J]. Surg Today, 2018, 48(1):44-50. doi: 10.1007/s00595-017-1545-3 URL
[29]	王翔, 蔡小泥, 祁春春, 等. 经内镜逆行胰胆管造影在胆道疾病合并胰胆返流中的应用[J]. 中华消化内镜杂志, 2019, 36(8):604-606.
[30]	Ando H. How to deal with intrahepatic bile duct stenosis in congenital biliary dilatation and pancreaticobiliary maljunction[M]// Kamisawa T, Ando H, Kamisawa T, et al. Pancreaticobiliary Maljunction and Congenital Biliary Dilatation. Singapore Springer: Singapore, 2018:219-225.
[31]	Ikegame K, Takano A, Watanabe H, et al. Biliary cancer developed after the reparative surgery for congenital choledochal cyst: a case report and review of the literature[J]. Int Cancer Conf J, 2016, 6(2):43-49.
[32]	Mizuguchi Y, Nakamura Y, Uchida E. Subsequent biliary cancer originating from remnant intrapancreatic bile ducts after cyst excision: a literature review[J]. Surg Today, 2017, 47(6):660-667. doi: 10.1007/s00595-016-1366-9 pmid: 27324392
[33]	Miyazaki M, Yoshitomi H, Miyakawa S, et al. Clinical practice guidelines for the management of biliary tract cancers 2015: the 2nd English edition[J]. J Hepatobiliary Pancreat Sci, 2015, 22(4):249-273. doi: 10.1002/jhbp.233 URL
[34]	Kusano T, Takano T, Tachibana K, et al. Whether or not prophylactic excision of the extrahepatic bile duct is appropriate for patients with pancreaticobiliary maljunction without bile duct dilatation[J]. Hepatogastroenterology, 2005, 52(66):1649-1653.

检查方法	ERCP	MRCP	静脉滴注胆道造影CT
可视化率（%）（伴先天性胆道扩展的患儿）	82	57	25
灵敏度（%）儿童	75	40~80	58~100
成人	90~100	82~100	20
成像	胆胰汇合部的详细解剖结构, 评估括约肌的动态功能	完整胆道系统及功能,分辨率较低,运动伪影	胆道解剖结构的高分辨率图像, 描绘胰胆管的连通性
侵入性	是	否	小于ERCP
适应证	内镜乳头括约肌切开、CBD取石、鼻胆管引流、胆道肿瘤诊治、胆汁采集等	儿童、成年病人首选	二线诊断方式,随访和复查
并发症	胰腺炎、出血、感染、穿孔、镇静相关不良事件	较少	辐射和造影剂不耐受

胰胆管汇合异常的诊治进展

Progress in diagnosis and treatment of pancreaticobiliary maljunction

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