目的探讨胰管结石的诊断和治疗方法。方法回顾性分析1996年6月-2012年6月所收治36例合并胰管结石病人的临床资料和随访疗效。结果36例患者均通过影像学检查方法（B超、SCT、MRCP、ERCP及内镜超声）得到诊断。根据胰管结石位置分为3型：I型位于胰头处，共22例；I型位于胰体尾处，共10例；I I型位于全胰腺，共4例。36例患者中，31例行手术治疗，3例行内镜下取石术，2例保守治疗。手术患者中17例行胰管切开取石+胰管空肠R-oux-en-Y吻合术，7例行胰十二指肠切除术，5例行胰体尾+脾脏切除术，2例行保留十二指肠的胰头切除术（DPPRH）。术后33例患者随访3个月～6年，其中31例患者反复上腹部疼痛完全缓解，术前8例合并糖尿病患者中5例血糖得到控制，术前4例合并脂肪泻患者中2例脂肪泻好转。其余3例患者失访。结论影像学检查是胰管结石的主要诊断手段，外科手术是胰管结石的主要治疗方法。%Objective To investigate diagnosis and management of pancreatic duct stones. Methods The clinical data of 36 recipients of pancreatic duct stones admitted from Jun.1996 to Jun.2012 in Henan Provincial People’s Hospital were studied retrospectively. Results The diagnosis of 37 cases of pancreatic duct stones was conifrmed by imaging examinations(Bultrasonography, CTmagnetic resonance cholangiopancreatograp MRCP, endoscopic retrograde cholangiopancreat ography ERCP and endoscopic ultrasonography EUS. pancreatic duct stones were found in the head of the pancreas(type I)in 22 patients,in the body and tail of the pancreas(type II)in 10 patients,and in all the pancreas(type III )in 4 patients. In 36 patients, of which 31 cases were underwent surgery, of which 3 cases were treated endoscopic lithotripsy and the 2 cases were conservative treatment. The operative methods were ancreatolithotomy with Roux-en-Y side-to-side pancreatic-cojejunostomy in 17 cases pancreaticcoduedenectomy in 7 cases , resection of the tail of pancreas combined with splenectomy in 5 case ,and duodenum-preserving pancreatic head resection in 2 case. Thirty-three cases were followed for 3 months to 6 years after operation. Altogether 31 cases with upper abdominal pain before operation,the abdominal pain disappeared. Among 8 cases with diabetes mellitus before operation,blood glucose returned to normal in 5 cases after operation. Among 4 cases with steatorrhea before operation,the steatorrhea disappeared in 2 cases. The remaining 3 patients were lost to follow. Conclusion Imaging examinations are the signiifcant methods for diagnosis and surgery is the main method of pancreatic duct stones.
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