Classification of pancreaticobiliary maljunction and its clinical features in adults. (16th November 2019)

• Record Type: Journal Article
• Authors: Yoshimoto, Kensuke; Kamisawa, Terumi; Kikuyama, Masataka; Kuruma, Sawako; Chiba, Kazuro; Igarashi, Yoshinori
• Is Part Of: Journal of hepato-biliary-pancreatic sciences. Volume 26:Number 12(2019)
• Page Start: 541
• Page End: 547
• Publication Date: 2019-11-16
• Subjects: Adults -- Amylases -- Biliary tract neoplasms -- Carcinogenesis -- Santorini duct; Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 617.556
• DOI: 10.1002/jhbp.691
• Languages: English
• ISSNs: 1868-6974

Abstract

Abstract: Background: In pancreaticobiliary maljunction (PBM), reflux of pancreatic juice and bile produces various pathological conditions in the biliary tract and pancreas. Clinical features according to the classification of PBM by confluence between the distal bile duct and the main pancreatic duct proposed in 2015 were evaluated in children. Methods: Clinical features and complicating diseases according to the PBM classification were evaluated in 168 adult PBM patients. Patency of Santorini duct and associated biliary carcinomas were evaluated in 123 patients. Results: Similar to children, there were significant differences in age ( P < 0.01) and type of common bile duct ( P < 0.01) between the groups of the classification. Unlike in children, there was no significant difference in the incidence of abdominal pain and hyperamylasemia. There were 87 associated biliary carcinomas (79 gallbladder carcinomas and eight cholangiocarcinomas). PBM patients with a cudgel‐type Santorini duct, which is greater than 2 mm in diameter, did not develop biliary carcinomas, compared to 61.1% of those with other types of Santorini duct ( P < 0.01). Conclusions: Clinical features according to the PBM classification in adults were different from those in children. Although biliary carcinomas were frequently seen in adult PBM patients, none of those with a cudgel‐type Santorini duct developed biliary carcinoma. Abstract : Highlight Yoshimoto and colleagues reported that clinical features according to the classification of pancreaticobiliary maljunction by confluence between the distal bile duct and the main pancreatic duct differed between adults and children. Although biliary carcinomas were frequently seen in adult patients, none of those with a cudgel‐type Santorini duct developed biliary carcinoma.