摘要
目的评价Oddi括约肌测压术（sphincter of Oddi manometry,SOM）在慢性胆胰疾病诊治中的应用价值。方法回顾分析我院2005年5月-2009年1月11例慢性上腹痛疑似Oddi括约肌功能紊乱（sphincter of Oddi dysfunction,SOD）在ERCP检查时接受SOM的临床资料,分析测压结果、ERCP诊治情况,并随访远期疗效。结果SOM结果正常2例（18.2%）,均为胆囊切除术后腹痛待查患者,未行乳头括约肌切开术（endoscopic sphincterotomy,EST）,长期随访腹痛无加重,未再因此就医。5例复发性胰腺炎和4例腹痛伴胆总管增宽的SOM均存在不同程度的异常：Oddi括约肌基础压力为（52.7±19.2）mm Hg（34-96.5mm Hg）;蠕动压力为（167.3±24.8）mm Hg（140-200mm Hg）。9例SOM结果异常者均接受EST治疗,术后随访7例（77.8%）获得良好效果,2例复发性胰腺炎再次行ERCP并放置胰管支架后获满意疗效。结论SOM有助于评价Oddi括约肌功能,尤其适用于胆囊切除术后腹痛怀疑为SODⅢ型的患者,可以帮助明确诊断SOD,指导ERCP治疗。
Objective To evaluate the efficacy of sphincter of Oddi manometry（SOM）in the patients with chronic cholangiopancreatic diseases.Methods Totally 11 patients with chronic upper abdominal pain suspected as sphincter of Oddi dysfunction（SOD）were enrolled in this study.The patients underwent SOM when receiving ERCP from May 2005 to January 2009.We analyzed the results of their SOM,ERCP,and long-term outcomes.Results Among the patients,2 cases（18.2%）,who had abdominal pain after cholecystectomy,showed normal SOM results and thus received no endoscopic sphincterotomy（EST）;the abdominal pain of the patients didn＇t get worse during follow-up and no further treatment was carried out.Abnormal SOM results were observed in 5 cases of recurrent pancreatitis and 4 patients with abdominal pain complicated with dilated common bile duct;their mean basic pressure of sphincter of Oddi was（52.7±19.2）mm Hg（34-96.5 mm Hg）and peristaltic pressure was（167.3±24.8）mm Hg（140-200 mm Hg）.These 9 patients received EST and then were followed up;seven of them（77.8%）achieved good outcomes,while the other two developed recurrent pancreatitis,and received ERCP again,during which stents were placed into the pancreatic duct resulting satisfying outcomes.Conclusions SOM is helpful in evaluating the function of sphincter of Oddi,especially for the patients with abdominal pain after cholecystectomy who are suspected to have SOD type Ⅲ.By using the method,we can confirm SOD,and manage further treatment under ERCP.
出处
《中国微创外科杂志》
CSCD
2010年第3期252-255,共4页
Chinese Journal of Minimally Invasive Surgery
