Double-duct sign: do not forget the gallstones.
Double-duct sign: do not forget the gallstones.
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双胆管征：不要忘记胆结石。
DOI：
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发表时间：
2013
影响因子：
2.1
通讯作者：
N. D. de Boer
中科院分区：
文献类型：
--
作者：
L. H. Oterdoom;S. V. van Weyenberg;N. D. de Boer
双管征是胆总管和胰管同时扩张，常由胰腺癌引起。我们提出一个病人绞痛疼痛在她的右上腹。在影像学和超声检查中，她有胆总管结石的双管征象，胰头未见肿块。我们进行了文献检索，结果表明，在某些胰腺癌可能性较高的患者中（例如放射成像上的黄疸或胰腺肿块），高达85%的患者确实患有胰腺癌。在未选择的人群中，无论出现何种症状，58%的患者在内窥镜逆行胰胆管造影（ERCP）中出现双管征象是由胰腺恶性肿瘤引起的。在没有黄疸但有双管征象的患者中，只有6%的患者患胰腺癌。ERCP对胰腺癌双管征象的敏感性为50-76%，特异性为63-80%。我们的患者有症状的胆总管结石，接受了简单的ERCP结石取出和乳头切除术，并转介胆囊切除术。
A double-duct sign is the combined dilatation of the common bile duct and pancreatic duct, often caused by cancer of the pancreas. We present a patient with colicky pain in the right upper quadrant of her abdomen. On radiological imaging and endosonography, she had a double-duct sign due to choledocholithiasis and no mass in the pancreatic head. A literature search was performed, which indicated that in selected patients with a higher likelihood of pancreas cancer (for example jaundice or pancreatic mass on radiological imaging) up to 85% of patients do indeed have a pancreatic cancer. In an unselected population, regardless of presenting symptoms, a double-duct sign on endoscopic retrograde cholangiopancreatography (ERCP) was caused by a pancreas malignancy in 58% of patients. In selected patients without jaundice but with a double duct sign, pancreas cancer was only seen in 6% of patients. The sensitivity and specificity of the double-duct sign observed by ERCP for pancreatic cancer varies between 50-76% and 63-80%, respectively. Our patient with symptomatic choledocholithiasis underwent an uncomplicated ERCP with stone extraction and papillotomy and was referred for a cholecystectomy.