师柳明　沈克锋　刘宏

[摘要] 随着各种影像诊断技术与微创治疗技术的发展，慢性胰腺炎导致良性胆总管狭窄的诊治向无创、微创发展。新近发展的各种影像检查技术具有显影清晰、无创、适用范围广、诊断率高、创伤小等特点，近年不断进展的微创手术方式相对于原来的开腹手术具有手术创伤小、术中出血量少、术后并发症发生率低及术后恢复快等优势，目前最新的达芬奇机器人手术系统已在国内逐步得到应用，解决了腹腔镜手术视野局限、器械操作不灵活等缺点。这些新技术被逐步应用于慢性胰腺炎导致的胆总管良性狭窄的诊治，本文就其研究进展进行综述。

[关键词] 慢性胰腺炎；胆总管狭窄；影像诊断进展；微创治疗

[中图分类号] R445.2；R576 [文献标识码] A [文章编号] 1673-9701（2015）35-0150-04

[Abstract] With the development of various diagnostic imaging techniques and minimally invasive treatment techniques， the diagnosis and treatment of benign biliary stenosis caused by chronic pancreatitis develop to non-invasive and minimally invasive. The newly developed imaging technology has the characteristics of clear， noninvasive，wide application and high diagnostic rate. In recent years the progress of minimally invasive operation mode compared to the original open operation has less trauma， less blood loss， lower incidence of postoperative complications and faster postoperative recovery and other advantages. The latest da Vinci robotic surgical system has been applied in China and has gradually solved the limitations of laparoscopic surgery，such as the field of vision， the operation is not flexible. Advances in diagnosis and treatment of benign biliary stenosis caused by chronic pancreatitis are reviewed for this article for reference.

[Key words] Chronic pancreatitis； Bile duct stenosis； Advances in diagnostic imaging； Minimally invasive treatment

隨着生活水平的持续提高，在我国酒精因素逐渐取代胆道系统疾病，成为慢性胰腺炎（chronic pancreatitis，CP）的最主要病因及危险因素[1]。有研究报道CP导致良性胆总管狭窄的发生率为2%～45.6%不等[2]，由慢性胰腺炎导致的胆总管纤维化或胰头炎性肿大压迫胆总管均可导致胆总管良性狭窄。慢性胰腺炎导致的良性胆总管狭窄越来越受到临床医生及患者的重视，胆总管狭窄可导致胆管内压力增高、胆管增宽及胆汁排放不畅，从而引起相应的临床表现。近年来随着各种影像学诊断技术及更先进的影像设备的出现，CP导致的良性胆总管狭窄的诊断水平较以前有了明显提高，现在大多数病例术前多能鉴别诊断。……