Pancreaticobiliary reflux in patients after choledocholithotomy and its relationship with clinicoradiological characteristics
10.3760/cma.j.cn113855-20250126-00060
- VernacularTitle:胆总管结石手术后胰胆反流及其临床影像学特点
- Author:
Li ZHANG
1
;
Lingfu ZHANG
1
;
Chunsheng HOU
1
;
Dianrong XIU
1
Author Information
1. 北京大学第三医院普通外科，北京 100191
- Publication Type:Journal Article
- Keywords:
Choledocholithiasis;
Pancreaticobiliary reflux;
Pancreaticobiliary maljunction;
Occult pancreaticobiliary reflux
- From:
Chinese Journal of General Surgery
2025;40(7):524-527
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the occurrence of pancreaticobiliary reflux and its clinical and imaging characteristics in patients after common bile duct stone surgery.Methods:A retrospective analysis of 123 patients who underwent bile amylase measurement after common bile duct stone extraction was conducted to analyze the occurrence of pancreaticobiliary reflux and its correlation with clinicoradiological data.Results:Among the 123 patients, 72 patients had pancreaticobiliary reflux (58.5%), of which 10 were in a state of high biliary amylase levels. Among the 32 patients who underwent simultaneous measurement of C-tube cephalic (liver side) and caudal (duodenal papilla side) amylase, the cephalic side amylase was lower than the caudal side amylase with a significant statistical difference ( P<0.001). Compared with patients without pancreaticobiliary reflux, patients in the status of pancreaticobiliary reflux and high biliary amylase levels were no statistically significant difference in age, gender, emergency visit, papillary diverticulum, preoperative biliary pancreatitis, preoperative common bile duct diameter, C-tube cholangiography common bile duct diameter, and imaging common bile duct diameter>10mm. Among the 123 patients in this group, 5 cases showed pancreaticobiliary maljunction on C-tube cholangiography, of which only 1 case had such manifestation by preoperative MRCP. There was no statistically significant difference in amylase levels between patients with pancreaticobiliary maljunction and patients with occult pancreaticobiliary reflux ( P=0.698). Conclusions:Pancreatic bile reflux is common among patients after choledocholithotomy, with a lack of preoperative clinical imaging predictive method. Bile amylase measurement is the key to diagnosis.
