胆胰管系统解剖在急性胆源性胰腺炎 发病中的作用

Role of Biliary and Pancreatic Duct Anatomy in the Pathogenesis of Acute Biliary Pancreatitis

摘要: 急性胆源性胰腺炎(acute biliogenic pancreatitis, ABP)是我国最常见的急性胆源性胰腺炎类型。其发病机制与胆胰管系统解剖结构密切相关。随着影像学技术的发展和对胆胰疾病认识的深入，胆胰管解剖在疾病发病机制中的作用日益受到重视。本文系统阐述了胆胰管解剖变异(如胰胆管合流异常、胰腺分裂等)、不同胆胰管汇合方式、汇合角度、共同管长度等对ABP发生风险的影响及其病理生理机制，特别探讨了共同通道学说的解剖学基础，这些解剖知识深刻影响着临床实践。未来，基于高精度成像和人工智能的个体化解剖风险评估，有望实现ABP的预测性防治和真正意义上的精准诊疗。胆胰管解剖是理解ABP发病机制的基石，将其纳入临床决策全流程，对改善患者预后具有重要意义。

Abstract: Acute biliogenic pancreatitis (ABP) is the most common type of acute pancreatitis in China. Its pathogenesis is closely related to the anatomical structure of the biliary and pancreatic duct system. With the advancement of imaging technology and a deeper understanding of biliary and pancreatic diseases, the role of biliary and pancreatic duct anatomy in disease pathogenesis has received increasing attention. This paper systematically elaborates on the influence of anatomical variations in the biliary and pancreatic ducts (such as pancreaticobiliary maljunction, pancreas divisum, etc.), different confluence patterns of the biliary and pancreatic ducts, confluence angles, common channel length, and their pathophysiological mechanisms on the risk of ABP, with special emphasis on the anatomical basis of the common channel theory. This anatomical knowledge profoundly impacts clinical practice. In the future, individual anatomical risk assessments based on high-precision imaging and artificial intelligence are expected to enable predictive prevention and true precision diagnosis and treatment of ABP. The anatomy of the biliary and pancreatic ducts serves as the cornerstone for understanding the pathogenesis of ABP. Integrating it into the entire clinical decision-making process is of great significance for improving patient prognosis.