目的　探讨胰胆管合流异常 (APBD)的表现特征及其与胆胰管病变的关系。方法　自1992年以来经直接胆道造影检查 76例胆胰管疾病患儿 ,经胆道留置外引流管造影 12例、经皮肝穿刺胆道造影 7例、内镜下逆行胆胰管造影 2例和术中胆胰管造影 5 5例。结果　 6 2例确定有APBD。APBD按Komi分类 ,Ⅰ型 (胆管汇入胰管 ) 2 9例、Ⅱ型 (胰管汇入胆管 ) 31例及Ⅲ型 (伴有副胰管的复杂型 ) 2例。 32例胆管囊状扩张中Ⅰ型 2 4例 ,2 2例胆管梭形扩张中Ⅱ型 18例 ,8例不伴胆管扩张中Ⅱ型 7例 (χ2 =32 .0 5 ,P <0 .0 1) ;18例胰腺病变中Ⅰ型 3例、Ⅱ型 13例及Ⅲ型 2例。胆管囊状扩张和梭形扩张组对比胆管远端内径 (0 .16± 0 .0 7)cmvs (0 .32± 0 .16 )cm ,P <0 .0 1。共通管直径 (0 .37± 0 .4 1)cmvs (0 .76± 0 .36 )cm ,P <0 .0 1、胰管直径 (0 .15± 0 .0 8)cmvs (0 .2 2± 0 .12 )cm ,P <0 .0 5及胰胆管交角 (70 .5°± 2 5 .1°)vs (36 .6°± 17.5°) ,P <0 .0 1,差异均有显著性意义。结论　不同的APBD类型可导致不同形式胆胰管病理变化 ,胆管远端狭窄近直角汇入胰管型多造成胆管囊状扩张 ,而胰管以锐角形式汇入胆管型多致胆管梭形扩张、胆管炎及胰腺炎。 Objective To investigate the characteristics of pancreaticobiliary duct anomalies (APBD) and its relationship with the pathological changes of biliary and pancreatic duct. Methods Totally 76 children with biliary and pancreatic duct diseases were examined by direct cholangiography since 1992. There were 12 cases underwent biliary indwelling external drainage catheterization, 7 cases underwent percutaneous transhepatic cholangiography, 2 cases underwent endoscopic retrograde cholangiopancreatography, Medium cholangiopancreatography 55 cases. Sixty-two patients were confirmed to have APBD. According to Komi classification, APBD was classified into 2 types: type Ⅰ (bile ducts inserted into the pancreatic duct), type Ⅱ (type Ⅱ) and type Ⅲ (complicated with accessory pancreatic duct). In 32 cases, 24 cases were type Ⅰ in cystic dilatation, 18 cases in type Ⅱ in 22 cases of biliary fusiform expansion, and 7 cases in type Ⅱ without biliary dilatation in 8 cases (χ2 = 32.050, P0.01 1). Among the 18 cases of pancreatic lesions, 3 were type Ⅰ, 13 were type Ⅱ and 2 were type Ⅲ. Biliary cystic dilatation and fusiform dilatation group compared with distal bile duct diameter (0 .16 ± 0. 0 7) cmvs (0.32 ± 0.16) cm, P <0. The diameter of common duct was (0.37 ± 0.41) cmvs (0.76 ± 0.36) cm, P <0.01, the diameter of pancreatic duct was (0.15 ± 0.08) cmvs (0.2 2 ± 0.12) cm, P <0.05, and pancreatic duct bile duct angle (70.5 ± 2.51 ° vs 36.6 ° ± 17.5 °, P <0.01, respectively) Have significant significance. Conclusion Different types of APBD can lead to pathological changes of different forms of bile duct and pancreatic duct. The stenosis of distal bile duct merges into the pancreatic duct at near right angle to cause cystic dilatation of the bile duct. However, Cholangitis and pancreatitis.