Cholangiographic criteria for anomalous union of the pancreatic and biliary ducts.
BACKGROUND
Anomalous union of the pancreatic and biliary ducts (AUPBD) is characterized by the intersection of these ducts proximal to the sphincter of Oddi. Thus, the relative anatomic relationship between the pancreaticobiliary ductal union and the narrow distal segment of the bile duct, which represents the functional sphincter, on cholangiopancreatograms determines whether the ductal union is normal or anomalous. This study examined whether the length of the common channel or that of the narrow distal segment is more closely associated with AUPBD and defined radiographic criteria for AUPBD.


METHODS
The length of the common channel and of the narrow distal segment were measured directly on cholangiopancreatograms from 350 patients.


RESULTS
AUPBD was found in 36 patients (10%). The common channel was significantly longer in patients with AUPBD (p < 0.001), whereas the length of the narrow distal segment was comparable between patients with and without AUPBD (p = 0.38). There was considerable overlap in the range of the length of the common channel between patients with and without AUPBD.


CONCLUSIONS
The length of the common channel is closely associated with the presence of AUPBD. However, a diagnosis of AUPBD based on the length of the common channel is not reliable. The diagnosis of AUPBD continues to rely on the radiographic criterion of a pancreaticobiliary ductal union located proximal to the narrow distal segment, which represents the sphincter of Oddi.
Nomura
Tatsuya
T
Department of Surgery, Niigata University School of Medicine, Niigata City, Japan.
Shirai
Yoshio
Y
Sandoh
Norimasa
N
Nagakura
Shigenori
S
Hatakeyama
Katsuyoshi
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017734:Bile Ducts, Extrahepatic / Q000002:abnormalities* / Q000000981:diagnostic imaging; D002758:Cholangiography; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000002:abnormalities* / Q000000981:diagnostic imaging