Ectopic distal location of the papilla of vater in congenital biliary dilatation: Implications for pathogenesis.
OBJECTIVE
This study investigates the relationship between the location of the papilla of Vater and the length of the common channel in patients with congenital biliary dilatation (CBD).


METHODS
Cholangiograms from 121 CBD patients and 13 normal controls were the subjects for this study. A length index defined as the length of the common channel divided by the height of the second lumbar vertebra was used for standardization.


RESULTS
In the controls, the papilla of Vater was located in the middle of the descending or second part of the duodenum in all cases. In 39 (32.2%) of the 121 CBD patients papilla of Vater was located in the descending duodenum (group I), and in 82 (67.8%) it was distal to the descending duodenum (group II). The average length index of the common channel in group II was significantly longer than in group I (1.123 +/- 0.374 v 0.660 +/- 0.246; P <.001). Findings for the common bile duct were similar.


CONCLUSIONS
There is a significantly higher incidence of ectopic distal location of the papilla of Vater in CBD patients than in controls. The more distal the location of the papilla of Vater, the longer the common bile duct and the common channel.
Li
L
L
Department of Pediatric Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
Yamataka
A
A
Yian-Xia
W
W
Da-Yong
W
W
Segawa
O
O
Lane
G J
GJ
Kun
W
W
Jin-Zhe
Z
Z
Miyano
T
T
D000293:Adolescent; D000328:Adult; D014670:Ampulla of Vater / Q000002:abnormalities* / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002758:Cholangiography; D015529:Choledochal Cyst / Q000000981:diagnostic imaging / Q000473:pathology*; D003135:Common Bile Duct / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000473:pathology; D004386:Duodenum / Q000033:anatomy & histology; D006801:Humans; D007223:Infant