The clinical analysis of endoscopic pancreaticobiliary separation in the treatment of occult pancreaticobiliary reflux
10.3760/cma.j.issn.1007-631X.2019.02.014
- VernacularTitle:内镜下胰胆分流术治疗隐匿性胰胆反流的临床分析
- Author:
Cheng ZHANG
1
;
Yulong YANG
;
Hai HU
;
Gang ZHAO
;
Meiju LIN
;
Yuefeng MA
;
Chunchun QI
Author Information
1. 同济大学附属东方医院胆石中心
- Keywords:
Cholecystolithiasis;
Amylases;
Biliopancreatic diversion
- From:
Chinese Journal of General Surgery
2019;34(2):147-150
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate endoscopic pancreaticobiliary separation (EPBS) in patients with gallstone and occult pancreaticobiliary reflux (OPBR).Methods The clinical data of 47 cases with gallstone and OPBR from Oct 2013 to Oct 2016 was analyzed retrospectively.Results The mean gallbladder bile amylase (GBA) was (864 ± 575) U/L.40 cases have undergone the treatment of endoscopic retrograde cholangiopancreatography.26 cases were diagnosed as duodenal papillitis,16 cases as periampullary diverticula,14 cases as long nipple,5 cases as atrophic papilla,3 cases as ampulla stone and 2 cases as papillary tumor.9 were diagnosed as pancreaticobiliary maljunction in the 14 patients with long nipple.33 cases were performed with EPBS.GBA was tested in 16 cases,and the GBA of 15 cases returned to normal level.The difference of GBA was statistically significant [(1 161 ±764) U/L vs.(47 ± 17) U/L,(t =5.641,P ＜ 0.05)].Patients were followed up for 1 to 4 years,among 36 cases without cholecystectomy,there was no recurrence of cholecystolithiasis after EPBS in 27 cases,but 2 cases had recurrent gallstones in 9 cases without EPBS,and the difference of gallstone recurrence rate was statistically significant (x2 =21.340,P ＜ 0.05).Conclusions Pancreaticobiliary junction diseases is an important cause for gallstone formation and OPBR.EPBS can avoid pancreaticobiliary reflux and reduce the recurrence rate of gallstone after choledochoscopic lithotomy.
