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Oddi括约肌病变的临床与组织学研究 被引量:6

Oddi sphincter lesions:a clinical and histological study
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摘要 目的研究Oddi括约肌病变的临床特征与组织学类型的相互关系。方法对1995年10月至2003年5月行经十二指肠Oddi括约肌切开成形术并术中切取括约肌组织活检32例,对标本行VanGieson染色切片。结果组织学检查仅1例正常,纤维化27例,占87%,腺体病变2例,炎症浸润2例。术中发现胆总管下端结石嵌顿、良性乳头狭窄、胰腺炎病变明显时括约肌为重度纤维化。胆总管泥沙状结石者的括约肌均有不同程度纤维化。结论胆管结石、炎症及急性胰腺炎之后均伴有Oddi括约肌纤维化,伴良性乳头狭窄时应考虑作括约肌切开术。 Objective To explore the relationship between the histological alterations of Oddi sphincter lesions and clinical manifestations. MethodsFrom October 1995 to May 2003, biopsies of Oddi sphincter were undertaken during transduodenal sphincteroplasty (TSP) in 32 cases. Specimens were stained with Van Gieson Mason staining. ResultsThirty one out of 32 specimens were found with histological alterations in Oddi sphincter including diffuse fibrosis in 87 1% (27/31) , adenomyosis in 2 cases and chronic inflammatory infiltration in 2 cases. Impacted stone in the terminal common bile duct, benign papillary stenosis and visible postpancreatitis parenchymal changes were all found accompanying severe fibrosis of Oddi sphincter. ConclusionIn patients with impacted stones in the ampulla, intracholedochal sludge with recurrent cholangitis, and relapsing pancreatitis, endoscopic sphincterotomy is recommended.
出处 《中华普通外科杂志》 CSCD 北大核心 2005年第5期298-300,共3页 Chinese Journal of General Surgery
基金 湖北省卫生厅科研基金资助项目(JX1C31)
关键词 ODDI括约肌 组织学 TSP 适应证 内窥镜 活组织检查 奥狄氏括约肌 括约肌切开术 十二指肠 Oddi′s sphincter Biopsy Sphincterotomy,endoscopic
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参考文献5

  • 1全卓勇,彭开勤,张应天.Oddi括约肌切开成形术168例临床分析[J].中国实用外科杂志,2002,22(7):411-413. 被引量:11
  • 2Linda JD, Geels W, Wilcox CM. Prevalence of sphincter of Oddi dysfuction: can results from specialized centers be generalized? Dig Dis Sci, 2002, 47: 2411-2415.
  • 3Silvermann WB, Slivka A, Rabinovitz M, et al. Hybrid classification of sphincter of Oddi dysfunction based on simplified milwaukee criteria: effect of marginal serum liver and pancreas test elevations.Dig Dis Sci, 2001, 46: 278-281.
  • 4Park SH, Watkins JL, Fogel EL, et al. Long-term outcome of endoscopic dual pancreatobiliary sphincterotomy in patients with manometry-documented sphincter of Oddi dysfunction and normal pancreatogram. Gastrointest Endosc, 2003, 57: 483-491.
  • 5Ponchon T, Aucia N, Mitchell R, et al. Biopsies of the ampullary region in patients suspected to have sphincter of Oddi dysfunction.Gastrointest Endosc, 1995, 42: 296-300.

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