Significance of the anomalous arrangement of the pancreaticobiliary duct in the etiology of biliary atresia
Significance of the anomalous arrangement of the pancreaticobiliary duct in the etiology of biliary atresia
复制标题
胰胆管异常排列在胆道闭锁病因中的意义
DOI：
10.1055/s-2007-965028
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发表时间：
2007-04-01
影响因子：
1.8
通讯作者：
Fumino, S.
中科院分区：
文献类型：
--
作者：
Deguchi, E.;Iwai, N.;Fumino, S.
背景/目的：胰胆管异常排列（AAPBD）是解释胆道闭锁病因的理论之一。我们调查是否AAPBD可以参与和评估其意义的病因胆道atresia.Materials和方法：43例胆道闭锁，胆总管和十二指肠之间的区域可以通过手术胆管造影可视化5例无法纠正类型的胆道闭锁。5例中3例显示胰胆管排列异常。对3例胰胆管异常排列的类型及共同沟的长度进行了术中胆道造影研究。结果：3例患者均表现为AAPBD，胰胆管连接处均为P-C型，胰胆管连接处均为P-C型。共同通道的长度范围为7 mm至12 mm。3例中有2例未显示血清淀粉酶水平升高。1例胆囊上皮增生，另2例无增生。胆囊和胆总管粘膜的炎症变化不显着，在这3例patients.Conclusions：从这些结果看来，AAPBD在胆道闭锁可能不是一个病因的肝外胆管闭锁，但可能是一个相关的异常胆道闭锁。应检查其他因素以明确导致肝外胆管管腔梗阻的病因。
Background/Purpose: The anomalous arrangement of the pancreaticobiliary duct (AAPBD) is one theory used to explain the etiology of biliary atresia. We investigated whether AAPBD could be involved and evaluated its significance for the etiology of biliary atresia.Materials and Methods: Of 43 patients with biliary atresia, the area between the common bile duct and the duodenum could be visualized by operative cholangiogram in 5 patients with an uncorrectable type of biliary atresia. Three of the 5 showed an anomalous arrangement of the pancreaticobiliary duct. In these 3 patients, the type of anomalous arrangement of the pancreaticobiliary duct and the length of the common channel were studied by operative cholangiogram. Histological findings of the gallbladder and the common bile duct were examined in addition to the measurement of the serum amylase levels.Results: All 3 patients showed AAPBD with the P-C type of pancreaticobiliary junction. The length of the common channel ranged from 7 mm to 12 mm. Two of the 3 cases did not show an elevated serum amylase level. Epithelial hyperplasia of the gallbladder was observed in one patient, while the other two showed no hyperplasia. Inflammatory changes in the mucosa of the gallbladder and the common bile duct were not remarkable in these 3 patients.Conclusions: From these results it seems that AAPBD in biliary atresia might not be an etiological factor for atresia of the extrahepatic bile duct, but might be an associated anomaly in biliary atresia. Other factors should be examined to clarify the etiological factor leading to lumenal obstruction of the extrahepatic bile duct.