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The Preliminary Study of Relationship between Occult Pancreaticobiliary Reflux and Biliary Diseases

Author: YangHuiHui
Tutor: JinChunXiang
School: Jilin University
Course: Clinical
Keywords: Occult pancreatic juice countercurrent Biliary diseases Bile amylase activity Common bile duct of △ bile in amylase activity
CLC: R657.4
Type: Master's thesis
Year: 2011
Downloads: 9
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Abstract

Objective: To investigate the occult secretin countercurrent correlation between (occult pancreaticobiliary reflux, OPR) and biliary system disorders. Methods: confirmed by color Doppler ultrasound, magnetic resonance cholangiopancreatography (magnetic retrograde cholangiopancreatography, MRCP), computed tomography scan (computed tomography, CT), primary biliary system diseases since December 2009 to February 2011 and proposed line treatment of patients. Surgery, endoscopic retrograde cholangiopancreatography (endoscopic retrograde cholangiopancreatograhy, ERCP) collected into the group of patients with common bile duct bile and bile amylase activity was measured immediately sex determination of serum amylase activity in the 48 hours before surgery gall calculated Explorer △ bile amylase enzyme activity (common bile duct in △ bile amylase activity = common bile duct in bile amylase activity - Serum amylase enzyme activity). All patients underwent preoperative ultrasound measuring the first liver doors at the common bile duct diameter, common bile duct wall thickness and wall thickness of the gallbladder. Study, we excluded patients with: (1) check MRCP, ERCP, CT diagnosis of patients maljunction (the pancreaticobiliary maljunction PBM, common bile duct and main pancreatic duct confluence after common pipe length gt; 15mm); (2 ) previous Oddi sphincterotomy history of patients; (3) patients unable to collect enough bile bile volume is too small; (4) check MRCP, ERCP, CT diagnosis of patients with biliary strictures; (5) pre-operative serum amylase The increased activity of the patient. If measured into the group of patients with common bile duct, bile amylase activity in serum amylase activity of not less than OPR, as the patients included in the OPR group otherwise included in the OPR group not occur. Results: the patients required a total of 44 cases, male 22 cases, female 22 cases, the male to female ratio of 1:1, ranging in age from 22 years old to 90 years old, the average age was 58 ± 16.32 years. 44 cases of patients with biliary diseases, the the OPR incidence of 72.7% (32/44). The OPR group of patients with common bile duct bile amylase activity was significantly higher than those without the the of bile amylase activity the OPR group of patients with common bile duct (P lt; 0.05). All patients with bile duct stones alone occurred OPR, the OPR was 100% (9/9) the average common bile duct bile amylase activity 1047.75 ± 1317.26IU / L, common bile duct stones associated with gallstone patients OPR incidence of 75% (12/15), common bile duct stones combined with OPR gallbladder stones in patients with common bile duct, bile amylase activity was 2456.89 ± 3311.98IU / L, 80% of the incidence of gallbladder stones in patients in the OPR (4/5), the incidence of common bile duct cancer patients OPR 50% (5/10). The OPR group in the biliary system disease in patients with common bile duct the △ bile amylase activity there is a statistically significant difference (P lt; 0.05). Ultrasound, we measured the 30 patients at the hilar common bile duct diameter, common bile duct wall thickness and gallbladder wall thickness, which occurred OPR for 21 cases. The ultrasound measured the first liver doors at the inner diameter of the common bile duct, common bile duct wall thickness and gallbladder wall thickness in the the OPR group and did not occur between the OPR group were not statistically different. The OPR set of common bile duct diseases common bile duct in △ bile amylase activity and common bile duct wall thickness and the first at the hepatic portal common bile duct diameter no correlation. Conclusion: The occurrence of the OPR and biliary diseases correlated with the occurrence of common bile duct stones and bile duct stones gallbladder stones are closely related, and may be one of the major risk factors for common bile duct stones.

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