Risk factors for pancreatitis in patients with anomalous union of pancreatobiliary duct.
OBJECTIVE
The clinical features of pancreatitis in patients with an anomalous union of the pancreatobiliary duct (AUPBD) are unclear. This study analyzed the clinical features, pathogenic mechanisms, risk factors, and clinical courses after treatment in AUPBD patients.


METHODS
The medical records and cholangiopancreatograms of 58 patients with AUPBD and a choledochal cyst diagnosed between 1982 and 2001 were retrospectively reviewed.


RESULTS
Sixteen (27.6%) out of the 58 AUPBD patients experienced pancreatitis. The incidence of pancreatitis was significantly higher in those patients with a long (>21mm) and wide (>5mm) common channel, a wide diameter of the proximal pancreatic duct (>2.5mm), the presence of a filling defect in the common channel, and the presence of a pancreatic duct anomaly (p<0.05). A bile duct diversion from the pancreatic duct by a choledochal cyst excision prevented the recurrence of pancreatitis in most cases. A duodenopancreatectomy was required in some cases.


CONCLUSIONS
The morphological characteristics of the common channel and pancreatic duct contribute to the development pancreatitis in AUPBD patients and bile reflux into the pancreatic duct might be the main mechanism of pancreatitis in these patients.
Jeong
J B
JB
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Whang
J H
JH
Ryu
J K
JK
Yoon
Y B
YB
Kim
Y T
YT
D000293:Adolescent; D000328:Adult; D000368:Aged; D001652:Bile Ducts / Q000002:abnormalities*; D002648:Child; D002675:Child, Preschool; D002758:Cholangiography; D015529:Choledochal Cyst / Q000150:complications / Q000601:surgery; D002768:Choledochostomy; D004065:Digestive System Abnormalities / Q000150:complications; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging; D010183:Pancreatic Ducts / Q000002:abnormalities*; D016577:Pancreaticoduodenectomy; D010195:Pancreatitis / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D055502:Secondary Prevention