Pancreas Bile Syndrome

　　The etiology of pancreatobiliary syndrome is not yet clear, and it may be related to environmental factors, genetic factors, dietary factors, and emotional and nutritional factors during pregnancy. The pathogenesis of the disease is not detailed, and it is a condition caused by the obstruction of the common bile duct due to compression by pancreatic head cancer.

　　Pancreatobiliary syndrome often has symptoms of indigestion, progressive painless jaundice, gallbladder enlargement, and liver enlargement. Sometimes, enlarged lymph nodes above the clavicle can be palpated, and ascites, diabetes, increased blood amylase, and cachexia are common in the late stage.

　　Pancreatobiliary syndrome is a condition caused by the obstruction of the common bile duct due to compression by pancreatic head cancer, characterized by progressive painless jaundice, gallbladder enlargement, liver enlargement, very little bile in the intestinal tract, leading to grayish stools. There are often symptoms of indigestion, abdominal or left upper quadrant pain, nausea, vomiting, bloating, and weight loss.

　　There are no effective preventive measures for pancreatobiliary syndrome. Early detection and early diagnosis are the key to the prevention and treatment of the disease. Pay attention to rest, combine work and rest, maintain an orderly life, keep an optimistic, positive, and upward attitude towards life. Keep regular eating and drinking, have regular living and sleeping habits, do not overwork, keep a cheerful mind, develop good living habits, and avoid smoking and alcohol.

　　The clinical examination methods for pancreatobiliary syndrome mainly include CT examination, total bilirubin in red blood cell serum, liver function examination, and B-ultrasound examination. CT can capture cross-sectional or three-dimensional images of the examined part of the human body, detect any minor lesions in the body, and no abnormalities appear in the contrast examination. Low-pressure X-ray duodenography shows dilatation and displacement of the duodenal ring. B-ultrasound and CT examination show enlargement of the pancreas and space-occupying lesions.

　　Patients with pancreatobiliary syndrome should have a light and nutritious diet, pay attention to dietary balance. It is advisable to eat high-protein, nutritious, rich in vitamins and minerals, and easily digestible high-calorie foods. It is forbidden to eat greasy, difficult to digest, fried, smoked, grilled, cold, spicy, and high-salt, high-fat foods.

　　The Western medical treatment methods for pancreatobiliary syndrome mainly include internal medicine treatment and surgery, as follows:

　　I. Internal medicine treatment

　　1. General treatment: Bed rest, light diet, small and frequent meals, quit smoking and alcohol.

　　2. Drug treatment: use drugs that can inhibit or reduce reflux and protect the gastric mucosa. The following drugs can be selected.

　　(1) Colestipol (Cholestyramine) is an anion exchange resin with affinity for bile acids, which can bind to bile acids after taking it, reduce the concentration of soluble bile acids, prevent the occurrence of gastritis, and require supplementation of fat-soluble vitamins for more than 3 months of medication.

　　(2) Domperidone is a dopamine receptor antagonist in the stomach, which strengthens peristalsis of the gastrointestinal tract, promotes gastric emptying, and reduces the contact time between bile salts and mucosa.

　　(3) The new-generation gastrointestinal prokinetic agent cisapride (Prepulsid) is a 5-HT4 receptor agonist, which increases the release of acetylcholine in the myenteric plexus by exciting cholinergic receptors, coordinates the movement of the gastric antrum, pylorus, and duodenum to increase gastric emptying, and has a good therapeutic effect on controlling the occurrence of DGR.

　　(4) Since bile acid needs to be mediated by H2 to cause damage to the gastric mucosa, anti-secretory drugs have a certain protective effect on the gastric mucosa.

　　(5) Ursodeoxycholic acid (UDCA) can inhibit the synthesis of bile acid, and after taking it, a large amount of ursodeoxycholic acid is excreted into bile, reducing the relative concentration of deoxycholic acid and lithocholic acid, thus achieving good efficacy.

　　(6) Aluminum hydroxide magnesium (Gastadex, Talcid) is a layered lattice structure, which can quickly neutralize stomach acid, reversibly inactivate pepsin, continuously prevent bile acid and lysophosphatidylcholine from damaging the gastric mucosa, enhance the protective effect of the gastric mucosal protective factors, and the total effective rate of treating bile reflux gastritis can reach 90%. In addition, double octahedral montmorillonite (Simeta), compound glutamine (Maizilin-S), compound trisilicate magnesium (Gawei Ping), sodium glycyrrhizinate (Shengweikang) and branched-chain starch can also be selected.

　　3. Parenteral nutrition therapy: keeps the gastrointestinal tract in a resting state, reduces the occurrence of bile reflux, and supplements the necessary calories and electrolytes.

　　Second, surgical treatment

　　Some patients, especially those with severe conditions, have little or no effect from medication, and often require surgical treatment. Among the surgical methods, Roux-en-Y surgery is the most effective.

　　Most patients recover well after internal medicine treatment. Some patients, especially those with severe conditions, have little or no effect from medication, and often require surgical treatment.