Origin of the long common channel based on pancreatographic findings in pancreaticobiliary maljunction.
OBJECTIVE
The origin of a long common channel in pancreaticobiliary maljunction was suggested to be the ventral pancreatic duct. Pathogenesis of long common channels was investigated by anatomically analysing the arrangement of pancreatic ducts in pancreaticobiliary maljunction.


METHODS
Cholangiopancreatography was performed for 66 cases of pancreaticobiliary maljunction and 200 controls. The accessory pancreatic duct was classified according to course and shape. In cases with long- or short-type accessory pancreatic duct, lengths of the main pancreatic duct from orifice to first inferior branch and junction with the accessory pancreatic duct, and the common channel were measured.


RESULTS
Lengths of the main pancreatic duct from orifice to first inferior branch or junction with the accessory pancreatic duct were significantly longer in cases of pancreaticobiliary maljunction cases with the long- or short-type accessory pancreatic duct than in controls (p<0.01). Lengths of the main pancreatic duct from first inferior branch to junction with the accessory pancreatic duct were roughly equivalent in pancreaticobiliary maljunction and controls.


CONCLUSIONS
Long common channels in pancreaticobiliary maljunction might be formed embryologically with adhesion of the right ventral pancreatic duct and the terminal portion of the bile duct.
Kamisawa
T
T
Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan. kamisawa@cick.jp
Egawa
N
N
Nakajima
H
H
Tsuruta
K
K
Okamoto
A
A
Matsukawa
M
M
D017734:Bile Ducts, Extrahepatic / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000473:pathology; D002760:Cholangiopancreatography, Endoscopic Retrograde; D004108:Dilatation, Pathologic; D006801:Humans; D010183:Pancreatic Ducts / Q000002:abnormalities* / Q000000981:diagnostic imaging; D012189:Retrospective Studies