ROLE OF DUODENAL BILE CRYSTAL ANALYSIS IN THE INVESTIGATION OF IDIOPATHIC PANCREATITIS
ROLE OF DUODENAL BILE CRYSTAL ANALYSIS IN THE INVESTIGATION OF IDIOPATHIC PANCREATITIS
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DOI：
10.1002/bjs.1800750517
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发表时间：
1988-05-01
影响因子：
9.6
通讯作者：
VALLANCE, D
中科院分区：
文献类型：
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作者：
NEOPTOLEMOS, JP;DAVIDSON, BR;VALLANCE, D
对26例病因已知的急性胰腺炎患者（11例归因于胆结石，15例归因于酒精）和37例无急性胰腺炎病史的患者（21例有胆结石，16例无胆结石）进行了十二指肠胆汁结晶分析，以检测胆结石。在这些组中，敏感性为64- 67%，特异性为94- 100%。对14例“特发性”胰腺炎患者的十二指肠胆汁进行分析，发现5例患者（36%）出现胆红素钙结晶（但不是胆固醇结晶）。其中三名患者在胆囊切除术时确诊为胆结石，另一名患者在“晚期”超声检查时有胆结石，但晶体呈阴性。因此，最初的“特发性”组中有29%的人确诊患有胆结石。胆结石分析显示，31例非胰腺炎对照组中有7例（23%）存在色素结石，而13例胰腺炎患者中有9例（69%）存在色素结石（P= 0.0048）。这些结果表明，十二指肠胆汁结晶分析（包括胆红素钙和胆固醇结晶）可能是一种有用的技术，为调查患者的“特发性”胰腺炎。
Duodenal bile crystal analysis for the detection of gallstones was assessed in 26 patients with acute pancreatitis of known aetiology (11 attributable to gallstones and 15 to alcohol) and in 37 patients without a history of acute pancreatitis (21 with gallstones and 16 without). The sensitivity was 64–67 per cent and the specificity was 94–100 per cent in these groups. Analysis of duodenal bile from 14 patients with ‘idiopathic’ pancreatitis revealed calcium bilirubinate crystals (but not cholesterol crystals) in 5 patients (36 per cent). Gallstones were confirmed at cholecystectomy in three of these patients and also in one other patient who had a gallstone on a ‘late’ ultrasound examination but was negative for crystals. Thus 29 per cent of the original ‘idiopathic’ group had gallstones confirmed. Gallstone analysis showed that pigment stones were present in 7 of 31 (23 per cent) non-pancreatitis controls compared with 9 of 13 (69 per cent) pancreatitis patients (P= 0·0048). These results suggest that duodenal bile crystal analysis (involving both calcium bilirubinate and cholesterol crystals) may be a useful technique for the investigation of patients with ‘idiopathic’ pancreatitis.