The Relationship Between Biliary Amylase and the Clinical Features of Choledochal Cysts in Pediatric Patients
The Relationship Between Biliary Amylase and the Clinical Features of Choledochal Cysts in Pediatric Patients
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DOI：
10.1007/s00268-012-1619-8
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发表时间：
2012-09-01
影响因子：
2.6
通讯作者：
Lee, Suk-Koo
中科院分区：
文献类型：
--
作者：
Jung, Soo-Min;Seo, Jeong-Meen;Lee, Suk-Koo
虽然不同年龄组胆总管囊肿（CC）的临床特征已被广泛研究，但临床特征差异的原因尚不清楚。为了确定胆淀粉酶与小儿CC临床特征的关系，比较两组不同淀粉酶水平患者的临床结果。自1995年5月至2010年8月，80例18岁以下行胆总管囊肿切除及肝空肠吻合术并测定胆道淀粉酶水平的患者被分为低淀粉酶水平组（淀粉酶水平< 200 U/L, n = 26）和高淀粉酶水平组（淀粉酶水平bb0 200 U/L， n = 54）。对他们的医疗记录进行了回顾性审查。低组的中位年龄为4个月（范围= 17天-169个月），高组的中位年龄为48个月（范围= 22天-147个月）（p = 0.008）。低组以黄疸为主要症状，高组以腹痛为主要症状。组织学上，低组以胆管增生和胆汁淤积为主，高组以门静脉炎症为主。两组之间的放射学表现和术前实验室数据也有显著差异。术后并发症仅发生在高剂量组。两组均无死亡病例。本研究显示小儿CC患者胆淀粉酶水平与临床表现的关系，提示胰胆管异常愈合（APBDU）存在不同的潜在病理生理。
Although the clinical features of choledochal cysts (CC) in different age groups have been widely studied, the causes of differences in clinical features are unknown. To determine the relationship between biliary amylase and the clinical features of CC in pediatric patients, clinical outcomes were compared in two groups with different amylase levels.From May 1995 to August 2010, 80 patients under 18 years old who underwent choledochal cyst excision and hepaticojejunostomy and measurements of biliary amylase levels were allocated to a low-amylase-level group (amylase level < 200 U/L, n = 26) and a high-amylase-level group (amylase level > 200 U/L, n = 54). Their medical records were retrospectively reviewed.The median age was 4 months (range = 17 days-169 months) in the low group and 48 months (range = 22 days-147 months) in the high group (p = 0.008). In the low group, jaundice was the most common symptom, while abdominal pain was the main symptom in the high group. In histological findings, bile duct proliferation and cholestasis predominated in the low group and portal inflammation predominated in the high group. Radiological findings and preoperative laboratory data were also significantly different between the groups. Postoperative complications occurred in the high group only. There was no mortality in either group.This study shows a relationship between biliary amylase level and clinical manifestations in pediatric patients with CC, implying that there are different underlying pathophysiologies with anomalous pancreaticobiliary ductal union (APBDU).