【摘要】 目的　探讨慢性胆源性胰腺炎（ＣｈｒｏｎｉｃＧａｌｌｓｔｏｎｅ Ｐａｎｃｒｅａｔｉｔｉｓ ＣＧＰ）的诊断和外科处理。方法　对１９８９～１９９９年手术治疗的１１例ＣＧＰ病人进行了回顾性复习。结果　①引起ＣＧＰ的胆系疾病有：胆囊和胆总管下端多发结石８例（７３％ ）；Ｏｄｄｉ氏括约肌炎性狭窄２例（１８％ ）；胰胆管合流异常１ 例；胆总管下段共同通道长度＞ ４ｍ ｍ 者７例（６４％ ）；②Ｂｕｓ、ＣＴ、ＭＲＩ等影像学检查见胰腺炎性肿块５例（４５％ ）；胰腺肿大或萎缩６例（５５％ ）；合并胰管扩张６例（５５％ ）；胰腺囊肿１ 例（９％ ）；③局灶性肿块切除术３ 例，分别为胰十二指肠切除术（Ｗｈｉｐｐｌｅ）２例，胰尾脾切除１例；胆道胰腺减压术８例，分别为胆囊切除和／或胆总管切开引流５例、Ｏｄｄｉ氏括约肌切开成形术２例、胰腺囊肿空肠Ｒｏｕｘ－ Ｙ吻合术１ 例。术后病理证实均为胰腺慢性炎症性改变。④随诊显示７例术后腹痛有不同程度的缓解或消失、黄疸消退、肿块缩小、症状好转。结论　胆总管下段共同通道存在具备了胆汁逆流的解剖学基础，壶腹部梗阻和感染性胆汁返流入胰管是引起ＣＧＰ的重要原因；影象学检查是诊断ＣＧＰ的主要根据；局灶性肿块不能排除恶性病变者更多还原

【Abstract】 Objective To discuss diagnosis and surgical management of chronic gallstone Pancreatitis(CGP).Methods Authors analyzed retrospectively 11 patients with CGP in our department from 1989-1999.Result ①Systematic bile duct diseases of included: CGP in 8 cases (73%);Inflamed stricture of Oddis phincter 2 cases (18%);Length of common confluence >4mm in 7 cases (64%).②Bus、CT、MRI image examine discovered:inflamed mass in pancreas in 5 cases (45%); swollen or atrophied pancreas in 6 cases (55%);combined pancreas duct dilatation in 6 cases(55%);pancreatic cyst in 1 case.③Excision of local mass had 3 cases:whipple operation 2 cases;excision of pancreatic cauda and spleen 1 case.Decompression had 8 cases:choleocystectomy and/or common bill duct drainage in 5 cases;Oddi sphincter’s incision and sphicteroplasty 2 caese;roux-y anastomose betwcen pancreatic cyst and jejumun 1 case Pathology exmination proved pancreatic chronic inflammation after operation.④followe up showed that bellyache had various degree’s relief or disappear,Jaundice subsided,Mass reduced;Clinic symptom improved.Conclution Disoder of confluence part of low segment of bill common duct possess the anatomy base of bile reflut.The obstruction of ampulla part and bille’s reflut into pancreas duct were important reason of CGP.Image check were mostly proof of diagnosis.Local mass that is difficult to exclude malignant disease shoud be resected.Decompression of bill duct and pancreas were operated for diffuse inflamation of pancreas.Due to shorter course of the diseases and less damage of function on pancreas,the effect of surgical treatments for CGP are good.更多还原