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目的探讨胰胆管合流异常与肝外胆道系统癌(胆囊癌和肝外胆管癌)的相关性。方法回顾性分析2008年1月～2009年12月连续857例患者行磁共振胰胆管造影的临床及影像学资料,测量其胆胰汇合角度及共同管长度,确诊胰胆管合流异常67例。随机在790例不伴有胰胆管合流异常的病例中抽取78例为对照组,与67例胰胆管合流异常的病例行对照研究,分析胰胆管合流异常与肝外胆道系统癌的相关性。结果 67例胰胆管合流异常的患者中发生胆系癌56.72%(38例),对照组中发生胆系癌14.10%(11例),两组病例中胆系癌发生率存在显著性差异(χ2=22.27,P<0.05)。胰胆管合流异常并发胆系癌的病例中,胰胆管汇合类型对胆系癌的分化程度无显著影响(χ2=2.70,P>0.05)。结论胰胆管合流异常与肝外胆道系统癌发生有显著相关性,而胰胆管汇合类型对胆系癌的分化程度无显著影响。
Objective To investigate the correlation between pancreaticobiliary duct anomalies and extrahepatic biliary system cancer (gallbladder cancer and extrahepatic bile duct cancer). Methods The clinical and imaging data of 857 consecutive patients who underwent magnetic resonance cholangiopancreatography from January 2008 to December 2009 were retrospectively analyzed. The confluence point of the gallbladder and pancreatic duct and the common tube length were measured, and 67 cases of pancreaticobiliary duct anomalies were confirmed. A randomized study of 790 cases without pancreaticobiliary duct anomalies was performed in 78 cases of control group and 67 cases of pancreaticobiliary duct anomalies were compared with each other to analyze the correlation between pancreaticobiliary duct anomalies and extrahepatic biliary system cancer. Results 67 cases of cholangiocarcinoma occurred in 56.72% (38 cases) and control group (14.10%) in 11 cases. The incidence of gallbladder carcinoma was significantly different between two groups (χ2 = 22.27, P <0.05). Among the cases of pancreaticobiliary duct anomalies complicated with biliary cancer, the type of pancreaticobiliary ductal junction had no significant effect on the differentiation of gallbladder carcinoma (χ2 = 2.70, P> 0.05). Conclusions The anomalies of pancreaticobiliary duct and extrahepatic biliary tract cancer have a significant correlation, while the type of pancreaticobiliary ductal junction has no significant effect on the differentiation of biliary cancer.