title: Many faces of pancreaticobiliary reflux.
abstract: Pancreaticobiliary reflux may occur either as a result of an anatomically abnormal pancreaticobiliary junction or because of a functionally impaired sphincter despite a normal radiological appearance. It is associated with a wide spectrum of biliary diseases, including gall bladder and bile duct carcinoma. Pancreaticobiliary maljunction and related biliary reflux have been studied extensively in Southeast Asian populations and associations with choledochal cyst and biliary malignancy defined. However, reflux in the absence of ductal malunion has only been described relatively recently and its significance with respect to biliary malignancy requires clarification. We present four cases of pancreaticobiliary reflux to demonstrate the varied associations of this under-recognized disorder and review the related management issues.
authors.affiliation: Upper Gastrointestinal Surgical Unit, Royal North Shore Hospital and North Shore Private Hospital, University of Sydney, Sydney, NSW 2065, Australia.
authors.forename: Nicholas E
authors.initials: NE
authors.lastname: Williams
authors.forename: Justin S
authors.initials: JS
authors.lastname: Gundara
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Hugh
authors.forename: Jaswinder S
authors.initials: JS
authors.lastname: Samra
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000150:complications / Q000175:diagnosis*; D010183:Pancreatic Ducts / Q000002:abnormalities; D009803:Sphincter of Oddi / Q000002:abnormalities; D046628:Sphincter of Oddi Dysfunction / Q000175:diagnosis* / Q000209:etiology