B Nagi1, R Kochhar, D Bhasin, K Singh. 1. Section of Radiodiagnosis, Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh 160 012, India.
Abstract
BACKGROUND: Anomalous junction of the pancreaticobiliary duct (AJPB) is a rare finding in endoscopic retrograde cholangiopancreatography (ERCP). We present our data on the incidence of AJPB and associated diseases. METHODS: A retrospective analysis of 2885 ERCPs performed over 15 years was done to study the incidence of AJPB and the diseases associated with this anomaly. RESULTS: Of the 2885 patients who underwent ERCP, AJPB was seen in 46 (1.6%). AJPB was taken as a common channel exceeding 15 mm in length with or without dilatation of the common channel. Anomalous junction was of type I in 50%, type II in 39.1%, and type III in 2.2% cases. Y-type anomalous junction was seen in 8.7% of cases. Choledochal cyst was found in 87% of patients. Other disorders associated with AJPB were gallstones, gallbladder polyps, gallbladder carcinoma, protein plugs. and pancreatic ductal calculi. Four patients with AJPB did not show any associated abnormality. CONCLUSION: AJPB is a rare finding, and the diagnosis is based on a common channel longer than 15 mm on ERCP. Choledochal cyst is the most common association with AJPB. We believe that the clinical spectrum of AJPB may unfold further with the widespread use of cholangiographic techniques.
BACKGROUND:Anomalous junction of the pancreaticobiliary duct (AJPB) is a rare finding in endoscopic retrograde cholangiopancreatography (ERCP). We present our data on the incidence of AJPB and associated diseases. METHODS: A retrospective analysis of 2885 ERCPs performed over 15 years was done to study the incidence of AJPB and the diseases associated with this anomaly. RESULTS: Of the 2885 patients who underwent ERCP, AJPB was seen in 46 (1.6%). AJPB was taken as a common channel exceeding 15 mm in length with or without dilatation of the common channel. Anomalous junction was of type I in 50%, type II in 39.1%, and type III in 2.2% cases. Y-type anomalous junction was seen in 8.7% of cases. Choledochal cyst was found in 87% of patients. Other disorders associated with AJPB were gallstones, gallbladder polyps, gallbladder carcinoma, protein plugs. and pancreatic ductal calculi. Four patients with AJPB did not show any associated abnormality. CONCLUSION: AJPB is a rare finding, and the diagnosis is based on a common channel longer than 15 mm on ERCP. Choledochal cyst is the most common association with AJPB. We believe that the clinical spectrum of AJPB may unfold further with the widespread use of cholangiographic techniques.
Authors: Kevin C Soares; Dean J Arnaoutakis; Ihab Kamel; Neda Rastegar; Robert Anders; Shishir Maithel; Timothy M Pawlik Journal: J Am Coll Surg Date: 2014-06-27 Impact factor: 6.113