Endoscopic ultrasonography for diagnosing anomalous pancreaticobiliary junction.
BACKGROUND
Anomalous pancreaticobiliary junction (a long common channel) is associated with choledochal cyst or biliary malignancy. We conducted a prospective study to assess the diagnostic value of endoscopic ultrasonography for anomalous pancreaticobiliary junction.


METHODS
In 188 adult patients with pancreatobiliary disease, the length of the common channel demonstrated by endoscopic ultrasonography was compared with that demonstrated by ERCP. In 25 patients with anomalous pancreaticobiliary junction (the common channel > 15 mm on ERCP), diagnostic accuracy of endoscopic ultrasonography for associated pancreatobiliary diseases was evaluated.


RESULTS
On endoscopic ultrasonography, the length of the common channel measured 16.3 +/- 5.8 mm (4 of 27 mm) in patients with anomalous junction; 12 mm or longer in 22 (88%) of 25 patients. In patients with a normal junction, endoscopic ultrasonography demonstrated the channel to be shorter than 7 mm. Endoscopic ultrasonography detected choledochal cyst (in 19 patients), gallstones (in 7), and acute pancreatitis (in 2). This imaging precisely differentiated gallbladder lesions, including carcinoma (4 patients) and mucosal hyperplasia (10 patients) in 14 of 16 patients. Endoscopic ultrasonography could be performed safely in outpatients.


CONCLUSIONS
Endoscopic ultrasonography is useful imaging method for patients with suspected anomalous pancreaticobiliary junction.
Sugiyama
M
M
First Department of Surgery, Kyorin University, School of Medicine, Tokyo, Japan.
Atomi
Y
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001660:Biliary Tract Diseases / Q000000981:diagnostic imaging*; D003135:Common Bile Duct / Q000002:abnormalities* / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D019160:Endosonography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000000981:diagnostic imaging*; D010183:Pancreatic Ducts / Q000002:abnormalities* / Q000000981:diagnostic imaging; D011446:Prospective Studies; D012680:Sensitivity and Specificity