Etiological analysis of bile duct dilatation

doi:10.3877/cma.j.issn.2095-3232.2016.06.011

Abstract

Abstract:

Objective

To investigate the causes of bile duct dilatation.

Methods

Clinical data of 1 430 patients with bile duct dilatation who were admitted to People's Hospital of Hainan Province between January 2000 and December 2014 were retrospectively analyzed. Among them, 876 were males and 554 were females, aged 13-85 years old with a median age of 56 years old. The informed consents of all patients were obtained and the local ethical committee approval was received. The causes and severity of bile duct dilatation were observed. The relationship between the degree of secondary bile duct dilatation and serum total bilirubin (TB) level was analyzed by Kruskal-Wallis rank-sum test.

Results

Congenital cystic dilatation of common bile duct accounted for 6.3% (90/1 430). And secondary bile duct dilatation accounted for 93.7% (1 340/1 430), including 28.4% (380/1 340) of mild dilatation, 35.8% (479/1 340) of moderate, 25.4% (341/1 340) of severe and 10.4% (140/1 340) of extremely severe. Common causes of secondary bile duct dilatation were common bile duct stone, pancreatic head carcinoma, periampullary carcinoma, extrahepatic cholangiocarcinoma and chronic pancreatitis, in the order. The degree of secondary bile duct dilatation induced by common bile duct stone, pancreatic head carcinoma, periampullary carcinoma and chronic pancreatitis was correlated with the serum TB level (H=29.401, 9.483, 9.722, 11.907; P<0.05).

Conclusions

Bile duct dilatation is mainly secondary. The common causes are common bile duct stone, pancreatic head carcinoma, periampullary carcinoma, extrahepatic cholangiocarcinoma and chronic pancreatitis, in the order. The degree of secondary bile duct dilatation induced by common bile duct stone, pancreatic head carcinoma, periampullary carcinoma and chronic pancreatitis is correlated with serum TB level.

Key words: Bile ducts, Dilatation, pathologic, Choledocholithiasis, Pancreatic neoplasms, Bile duct neoplasms, Pancreatitis, chronic

Yunfu Lyu, Haiying Wu, Qing'an Qiu, Ning Liu, Jie Qiu, Hongfei Wu, Shunwu Chang. Etiological analysis of bile duct dilatation[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2016, 05(06): 390-393.

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References 20

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病因		例数	构成比（%）	胆总管扩张程度
病因		例数	构成比（%）	轻度	中度	重度	特重度
先天性		?	?	?	?	?	?
?	先天性胆总管囊性扩张	90	6.3	-	-	-	-
继发性		?	?	?	?	?	?
?	胆总管结石	476	33.3	91	201	145	39
?	胰头癌	179	12.5	42	69	41	27
?	壶腹周围癌	159	11.1	17	66	59	17
?	肝外胆管癌	89	6.2	29	18	17	25
?	慢性胰腺炎	80	5.6	40	20	14	6
?	胆管炎	53	3.7	8	23	13	9
?	胆道寄生虫	51	3.6	43	8	0	0
?	胆囊切除术后	51	3.6	41	10	0	0
?	十二指肠乳头癌	40	2.8	4	7	23	6
?	胆囊癌	30	2.1	10	12	5	3
?	慢性胆囊炎伴颈部结石嵌顿	28	2.0	20	7	1	0
?	肝门部转移瘤	17	1.2	1	3	8	5
?	十二指肠球部溃疡	16	1.1	10	5	1	0
?	胆肠吻合口狭窄	15	1.0	4	7	4	0
?	胆管狭窄	14	1.0	4	5	3	2
?	胆道出血	10	0.7	4	5	1	0
?	Minizzi综合症	10	0.7	1	5	3	1
?	缩窄性乳头炎	9	0.6	3	4	2	0
?	Oddi括约肌松驰	6	0.4	3	2	1	0
?	乳头旁憩室炎	4	0.3	3	1	0	0
?	十二指肠梗阻	3	0.2	2	1	0	0

病因		例数	构成比（%）	胆总管扩张程度
病因		例数	构成比（%）	轻度	中度	重度	特重度
先天性		?	?	?	?	?	?
?	先天性胆总管囊性扩张	90	6.3	-	-	-	-
继发性		?	?	?	?	?	?
?	胆总管结石	476	33.3	91	201	145	39
?	胰头癌	179	12.5	42	69	41	27
?	壶腹周围癌	159	11.1	17	66	59	17
?	肝外胆管癌	89	6.2	29	18	17	25
?	慢性胰腺炎	80	5.6	40	20	14	6
?	胆管炎	53	3.7	8	23	13	9
?	胆道寄生虫	51	3.6	43	8	0	0
?	胆囊切除术后	51	3.6	41	10	0	0
?	十二指肠乳头癌	40	2.8	4	7	23	6
?	胆囊癌	30	2.1	10	12	5	3
?	慢性胆囊炎伴颈部结石嵌顿	28	2.0	20	7	1	0
?	肝门部转移瘤	17	1.2	1	3	8	5
?	十二指肠球部溃疡	16	1.1	10	5	1	0
?	胆肠吻合口狭窄	15	1.0	4	7	4	0
?	胆管狭窄	14	1.0	4	5	3	2
?	胆道出血	10	0.7	4	5	1	0
?	Minizzi综合症	10	0.7	1	5	3	1
?	缩窄性乳头炎	9	0.6	3	4	2	0
?	Oddi括约肌松驰	6	0.4	3	2	1	0
?	乳头旁憩室炎	4	0.3	3	1	0	0
?	十二指肠梗阻	3	0.2	2	1	0	0

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