Objective To summarize the principle and application of functional MR imaging of pancreatic carcinoma and chronic mass-forming type pancreatitis. Methods Articles about diffusion-weighted imaging (DWI), magnetic resonance spectrum imaging (MRSI) and dynamic contrast-enhanced MR imaging of pancreatic carcinoma and chronic pancreatitis were reviewed and analyzed. Results Functional MR imaging could reflected the differences in molecules diffusion, metabolism and tissue perfusion between pancreatic carcinoma and chronic pancreatitis. Conclusion As a non-invasive protocol, functional MR imaging can provide useful information in differential diagnosis between chronic mass-forming type pancreatitis and pancreatic carcinoma.
目的 探讨胰管结石慢性胰腺炎的诊断和治疗。方法 收集我院1993年3月至2003年9月经手术治疗的胰管结石慢性胰腺炎患者34例的临床资料并进行回顾性分析。结果 全组病例均经B超和CT检查确诊，均经手术治疗。手术方式： 胰十二指肠切除术5例； 胰管切开取石、胰空肠Roux-Y吻合术27例，其中同时行胆囊切除术6例，Oddi扩约肌切开、T管引流术4例，胆肠Roux-Y吻合术2例； 胃空肠、胆肠吻合加活检术2例。治愈31例，缓解2例，死亡1例。结论 影像学检查是诊断本病的重要手段，准确率高。根据合并症和胰管扩张程度选择合适的手术方式，可取得良好治疗效果。
【摘要】目的探讨慢性胰腺炎的诊治方法。方法对1997年5月至2002年11月期间所收治并经临床或病理证实的114例慢性胰腺炎患者的资料进行回顾性分析。结果主要临床表现为腹痛、体重下降、腹胀和消化不良。影像学特征为胰腺肿块、假性囊肿、胰管扩张和胰管结石。本组中有60例行外科手术治疗，术后发生并发症4例，死亡1例，其余54例经保守治疗症状缓解。结论慢性胰腺炎临床表现和影像学表现变化多样，应根据病变特点选择手术方式。
慢性胰腺炎是一种胰腺的进展性和不可逆性炎症病变，最终将导致胰腺结构破坏和内、外分泌功能的丧失。病程通常呈反复发作性，表现为复发性腹痛或慢性无痛综合征。急性胰腺炎、慢性胰腺炎和胰腺癌这三种疾病之间存在着较复杂的关系。急性胰腺炎的发作通常先于慢性胰腺炎几年时间，而胰腺癌往往是在慢性胰腺炎明确诊断后20年左右发生，关于他们在发病上是否存在着一定的序贯性或是有其他短暂的联系，目前仍有争论。一些资料完整的临床病例随访分析提示，长期患慢性胰腺炎的患者发展为胰腺癌的危险性明显高于普通人群。
慢性胰腺炎是胰腺进行性炎症性疾病，以胰腺实质持续性破坏和纤维化等不可逆性的形态改变为其特征，并引起顽固性疼痛和(或)永久性功能丧失。迄今，其发病机理、病理生理和疾病过程仍不十分清楚，各种治疗也仅限于疾病的并发症。
Objective To discuss the methods of producing experimental models of chronic pancreatitis and their individual properties. Methods The recent literatures about experimental models of chronic pancreatitis were reviewed and analyzed. Methods of producing experimental models and their individual properties were summarized, and best models suitable for varied chronic pancreatitis were afforded. Results Diet, ligation of pancreatic duct, caerulein, dibutyltin dichloride (DBTC), arterial ligation, injecting microspheres into artery, and injection of pancreatic duct could induce different experimental models of chronic pancreatitis. Spontaneous chronic pancreatitis was induced by diet, chronic obstructive pancreatitis produced by ligation and injection of pancreatic duct, chronic relapsing pancreatitis evoked by caerulein, and chronic active pancreatitis made by arterial ligation and injecting microspheres into artery.Conclusion Different methods could induce models of chronic pancreatitis, which had their individual properties.
ObjectiveTo study the expression of HOX A9 mRNA and its clinicopathological significance in the benign and malignant lesions of pancreas. MethodsIn situ hybridization for HOX A9 mRNA was used on routine paraffinembedded sections. ResultsThe positive rate and scoring mean of HOX A9 mRNA expression was significanfly lower in pancreatic carcinoma (49%, 3.3±2.1) than that in chronic pancreatitis (95%, 5.4±0.8) and pericancerous tissues (80%, 4.6±1.2), the negative case of HOX A9 mRNA in chronic pancreatitis and pericancerous tissues showed middle or severelyatypical hyperplasis of the ductal epitheli. The positive rate and scoring mean of HOX A9 mRNA expression was significantly higher in the cases of welldifferentiation (63%, 4.0±2.2) or without metastasis (64%, 4.1±2.2) than that in the ones of poorlydifferentiation (32%, 2.6±2.3) or with metastasis (32%, 2.7±2.2). ConclusionThe expression of HOX A9 mRNA might be related the carcinogenesis, progress, biological behaviors, and prognosis of pancreatic carcinoma. The assay of HOX A9 mRNA expression in the benign lesions of pancreas might have important clinical values in the prevention and earlystage finding of the pancreatic carcinoma.
To evaluate the present status of treatment of chronic pancreatitis, 116 consecutive patients with chronic pancreatitis during the last decade (1986～1996) have been surveyed retrospectively. The clinical date has been analized statisticaly. Etiology: biliogenic 56 cases (48.3%), alcoholic 17 (14.6%), idiopathic 34 (29.3%) and other 9 cases (7.8%). Better result was achieved in surgical treatment group (81 cases) than in conservative group (35 cases), pain free: 65.5% vs 33.3%. The accumulated five-year survival rate was 56.3%, 92.2% and 78.1% in alcoholic, billiogenic and idiopathic type of chronic pancreatitis respectively. Morbidity and mortality of diarrhea and diabetes mellitus increased at followup. The authors conclude that the chronic pancreatitis patients associated with obstruction of biliopancreatic duct should undergo operation early and will ameliorate abdominal pain.
Nineteen cats were randomly divided into two groups, 7 cats (group A) recieved about 200 times spotty injections of total of 2 ml of 94% alcohol in pancreatic parenchyma and 12 cats (group B) underwent intraductal alcohoh, partial obstruction of the main pancreatic duct (MPD) and intraparenchymal alcohol. Acute necrotizing pancreatitis occurred in all of the experimental cats after operation. 2 cats in group A (28.6%) died within 48 hours postoperatively. 4 cats in group B (33.3%) died, among them, 3 within 48 hours and 1 died after 2 weeks. Morphological and functional recovery of the exocrine pancreas were found in all the 5 survivals in group A, while 8 cats in group B developed chronic pancreatitis 15 weeks after the operation. The above results show that simple pancreatic necrosis can be recovered after eliminating the etiological factors and if these factors, whatever is primary or secondary still exist and continue to damage the pancreas, chronic pancreatitis may develop.