中文摘要：

目的探讨胰管结石的分型方法，并根据分型选择合理的外科治疗方式。方法回顾性分析2000年1月至2010年12月89例接受手术治疗的胰管结石患者，男性57例，女性32例，平均年龄（52±23）岁。所有患者都经磁共振胰胆管成像确诊，根据结石的位置、胰管有无狭窄，将胰管结石分为3型：I型43例，胰石位于主胰管，主要采用内镜取石或胰管切开取石＋胰管空肠吻合术；Ⅱ型39例，胰石同时位于主胰管和分支胰管，主要采用胰管切开取石＋胰管空肠吻合术和（或）胰腺区段切除；Ⅲ型7例，结石位于分支胰管，主要采用胰腺区段切除。结果全组病例手术均获得成功，术后胰漏6例（6．7％），经非手术治疗后痊愈；吻合口出血2例（2．2％），其中1例死亡；结石残留6例（6．7％），均为分支胰管结石残留。78例获得随访，57例生存至今；5例患者有间隙性腹痛需要内科治疗，7例患糖尿病（2例为胰腺次全切除，5例为胰体尾切除），结石复发5例，其中3例行第2次手术。结论根据结石在胰管内而不是在胰腺实质的部位提出的胰管结石分型方式，对于以“取尽结石并保留胰腺功能”为原则的胰管结石外科治疗具有一定的指导价值。

英文摘要：

Objective To explore the improvement of typing and reasonable surgical treatment for pancreatic ductal stone （PDS）. Methods Totally 89 patients with pancreatic ductul stone treated underwent surgeries from January 2000 to December 2012 were involved into this study. There were 57 male and 32 female patients, the average age was （52 ~ 23 ） years. According to the magnetic resonance cholangiopancreatography imaging and finding during surgery, pancreatolithiasis was classified into three types ： type I , the stones were located in the main pancreatic duct; type II, the stones were located both in main and branch pancreatic duet; type m, the stones were diffusely scattered in the branch pancreatic duct; the position of PDS within pancreatic parenchyma were subtitled. In this group, 43 type I PDS were extracted with endoscopic papillotomy or endoscopic pancreatic sphincterotomy, or pancreatolithotomy plus pancreato-jejunal lateral anastomosis with wide anastomotie stoma; 39 type II cases were treated by pancreatolithotomy plus pancreato-jejunal lateral anastomosis or/and resection of pancreatic section; 7 type III PDS were managed with resection of pancreatic section, Results All surgeries were performed successfully. Among complications, 6 cases （6.7%） were pancreatic leakage which recovered after systematic non-surgical treatment, 2 eases （2. 2% ） were anastomotic bleeding which led to 1 death, 6 cases （6.7%） were residual pancreatolithiasis in branch pancreatic duct type. Seventy-eight patients were followed up for 6 to 131 months, 57 cases were still alive so far. Five cases were intermittent abdominal pain, 7 cases were diabetes resulted from 2 subtotal pancreatectomy and 5 distal pancreatectomy, 5 cases occurred pancreatolithiasis recurrence and 3 underwent secondary surgeries. Conclusions The basis of this modified typing of pancreatolithiasis is the position of stone in pancreatic duct rather than pancreas parenchyma. It is more important and valuable for surgical principle of taking ston