目的 探讨超声内镜对胰管结石的诊断价值及相关治疗方法.方法 回顾性分析2008年1月～2010年12月间我院收治的4例胰管结石的临床资料.结果 4例患者超声内镜检查均有慢性胰腺炎的影像学表现,胰腺内点状或弧形强回声,伴声影,胰管壁不规则,胰管扩张或囊性扩张.2例合并胰腺癌,1例合并壶腹癌,1例单纯胰管结石.治疗方法:1例行胰十二指肠切除术；1例行胆肠吻合术；1例行全麻下胰管切开取石,胰肠吻合术；1例行ERCP+ EST+支架植入术.结论 影像学检查是确诊胰管结石的主要手段,且超声内镜更具优势；胰管结石易合并胰腺癌,应该加以重视；治疗方法应根据具体情况采取不同的措施.%Objective To explore the value of endoscopic ultrasonography in the diagnosis of pancreatolithiasis and the treatment of pancreatolithiasis. Methods The clinical data of 4 patients with pancreatolithiasis treated in our hospital from January 2008 to December 2010 were retrospectively analyzed. Results Four cases of pancreatolithiasis were diagnosed by EUS, manifested as the imageological features of chronic pancreatitis, and showed dot-like or arc-shaped strong echo with acoustic shadows within the pancreas. The pancreatic duct wall was irregular, dilatant or saccular dilation. Two cases were complicated with pancreatic carcinoma. One case was complicated with ampullary carcinoma. One case had abdominal discomfort. They underwent pancreaticoduodenectomy, choledochojejunostomy, pancreatolithotomy plus side-to-side pancreaticojejunostomy, and ERCP + EST + Stent respectively. Conclusion Imaging is the primary means of diagnosis of pancreatolithiasis, and EUS is the best imaging method. There was high incidence of pancreatolithiasis complicated with pancreatic carcinoma, so we should attach importance to this. The different treatments should be given based on patients' situations.
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