[Common channel for bile and pancreatic ducts. Presentation of 12 cases and discussion].
Between 1978 and 1985, 11 girls and one boy underwent an elective operation for a congenital choledochal dilatation associated with an anomalous biliopancreatic junction. In 10 out of these 12 cases the children suffered several episodes of abdominal pain, and the diagnosis was missed since a jaundice appeared. The ultrasonographic examination demonstrated in all cases a dilatation of both extra- and intrahepatic bile ducts. The preoperative diagnosis was always established by the mean of a transhepatic cholangiography (8 cases) or a percutaneous cholecystography (4 cases), which showed in every case a dilated choledochus, and a common biliopancreatic channel, 15 to 35 mm long. A high amylase level was found in the bile in 10/10 cases when it was measured. A cholecystokinin test was performed in 4 cases, resulting in each case in a considerable increase of amylase and lipase levels in bile. All children were treated by excision of the dilated choledochus and gallbladder, followed by an hepaticojejunostomy with a Roux en Y loop. The follow-up is 6 months to 5 years for 9 children: 8 are cured, and on girl, who had a major dilatation of the left intrahepatic bile ducts, suffered from episodic abdominal pain and an episode od cholangitis 6 years after the operation. The role of such a common channel in the pathogeny of congenital choledochal cysts, acute pancreatitis in children, and biliary carcinomas in young adults is discussed according to the literatures of the last 10 years.
D000293:Adolescent; D001652:Bile Ducts / Q000002:abnormalities* / Q000601:surgery; D001653:Bile Ducts, Intrahepatic / Q000002:abnormalities / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D002758:Cholangiography; D003137:Common Bile Duct Diseases / Q000151:congenital* / Q000175:diagnosis / Q000601:surgery; D003560:Cysts / Q000151:congenital* / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010183:Pancreatic Ducts / Q000002:abnormalities* / Q000601:surgery; D010195:Pancreatitis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D014463:Ultrasonography
Canal commun bilio-pancréatique. Présentation de douze observations et discussion.