title: Acute pancreatitis and a long common channel.
abstract: BACKGROUND
  As sphincter action does not functionally affect the union in pancreaticobiliary maljunction (PBM), two-way regurgitation occurs. We investigated the features of acute pancreatitis associated with patients displaying a long common channel.
  
  
  METHODS
  We reviewed 3210 endoscopic retrograde cholangiopancreatograms. PBM was diagnosed in 107 patients with a long common channel in which communication between the pancreatic and bile duct was maintained even during sphincter contraction. High confluence of pancreaticobiliary ducts (HCPBD) was diagnosed in 60 patients with a common channel >or=6 mm long in which communication between the two ducts was occluded with sphincter contraction.
  
  
  RESULTS
  Of patients with PBM, four had acute pancreatitis. Etiology of acute pancreatitis in the two patients was suspected to involve impaction in a long common channel. Of patients with HCPBD, 17 displayed acute pancreatitis. Three patients had a history of excessive alcohol intake and 10 patients were associated with choledocholithiasis or cholecystitis. The remaining four patients had no history of them.
  
  
  CONCLUSIONS
  Acute pancreatitis occurs in 13% of patients with a long common channel. Obstruction of a long common channel by stones easily induces bile flow into the pancreas. Even if no obstruction is present, biliopancreatic reflux induces acute pancreatitis in some patients.
authors.affiliation: Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, 3-18-22 Honkomagome, Tokyo, 113-8677, Japan. kamisawa@cick.jp
authors.forename: Terumi
authors.initials: T
authors.lastname: Kamisawa
authors.forename: Yuyang
authors.initials: Y
authors.lastname: Tu
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Nakajima
authors.forename: Naoto
authors.initials: N
authors.lastname: Egawa
authors.forename: Kouji
authors.initials: K
authors.lastname: Tsuruta
authors.forename: Atsutake
authors.initials: A
authors.lastname: Okamoto
authors.forename: Masakatsu
authors.initials: M
authors.lastname: Matsukawa
mesh_terms: D000208:Acute Disease; D001652:Bile Ducts / Q000002:abnormalities / Q000473:pathology*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D006801:Humans; D010183:Pancreatic Ducts / Q000002:abnormalities / Q000473:pathology*; D010195:Pancreatitis / Q000473:pathology* / Q000503:physiopathology