Endoscopic retrograde cholangiopancreatography in the evaluation of anomalous junction of the pancreaticobiliary duct and related disorders.
BACKGROUND
Anomalous junction of the pancreaticobiliary duct (AJPB) is a rare finding in endoscopic retrograde cholangiopancreatography (ERCP). We present our data on the incidence of AJPB and associated diseases.


METHODS
A retrospective analysis of 2885 ERCPs performed over 15 years was done to study the incidence of AJPB and the diseases associated with this anomaly.


RESULTS
Of the 2885 patients who underwent ERCP, AJPB was seen in 46 (1.6%). AJPB was taken as a common channel exceeding 15 mm in length with or without dilatation of the common channel. Anomalous junction was of type I in 50%, type II in 39.1%, and type III in 2.2% cases. Y-type anomalous junction was seen in 8.7% of cases. Choledochal cyst was found in 87% of patients. Other disorders associated with AJPB were gallstones, gallbladder polyps, gallbladder carcinoma, protein plugs. and pancreatic ductal calculi. Four patients with AJPB did not show any associated abnormality.


CONCLUSIONS
AJPB is a rare finding, and the diagnosis is based on a common channel longer than 15 mm on ERCP. Choledochal cyst is the most common association with AJPB. We believe that the clinical spectrum of AJPB may unfold further with the widespread use of cholangiographic techniques.
Nagi
B
B
Section of Radiodiagnosis, Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh 160 012, India.
Kochhar
R
R
Bhasin
D
D
Singh
K
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001660:Biliary Tract Diseases / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D002760:Cholangiopancreatography, Endoscopic Retrograde; D015529:Choledochal Cyst / Q000453:epidemiology; D003135:Common Bile Duct / Q000002:abnormalities*; D000013:Congenital Abnormalities / Q000453:epidemiology; D016208:Databases, Factual; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000002:abnormalities*; D012189:Retrospective Studies