Dorsal Pancreatic Duct Dominance in Pancreaticobiliary Maljunction

Kamisawa, Terumi; Maruyama, Michio; Hasegawa, Kumi; Ohbu, Masahide; Koide, Ayaki; Matsushita, Noriko; Ando, Masami

doi:10.1016/s0016-5107(05)01041-2

Cited by 2 publications

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“…As for the cause of annular pancreas, Baldwin’s theory explains typical causes of this condition, in which the left lobe of the ventral pancreatic anlage (which normally disappears) remains and grows as forming a ring [17]. Kamisawa [1] supported Baldwin’s theory because many cases of annular pancreas exhibited thin pancreatic parenchyma with histologically proven fibrotic tissues, indicating that annular pancreas is formed from the left lobe of ventral pancreatic anlage (which normally regresses). As for the cause of pancreaticobiliary maljunction, Oi claimed that the pathological mechanism of this disorder should be an abnormal junction of the bile and pancreatic ducts in ventral pancreatic anlage, because a dorsal pancreatic duct was almost always normal [18].…”

Section: Discussionmentioning

confidence: 99%

“…At approximately 6–7 weeks of gestation, in association with the 90-degree rotation of the stomach and duodenal loop, the ventral anlage moves to the rear with rotation around the duodenum and then ventrally approaches the dorsal anlage. Finally, both the ventral and dorsal anlages assimilate to form the pancreas [1]. Thus, pancreatic development is so complicated that congenital abnormalities often occur.…”

Section: Introductionmentioning

confidence: 99%

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Pancreaticobiliary maljunction diagnosed long after laparotomy in the neonatal period for annular pancreas: report of a case

et al. 2019

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Background Although annular pancreas concurrent with pancreaticobiliary maljunction has rarely been reported, some reports have pointed out a possibility that both anomalies have a common pathogenesis in pancreatic development. We herein report a case with pancreaticobiliary maljunction diagnosed long after surgical treatment for annular pancreas. Case presentation A 34-year-old female, with a surgical history of duodenal obstruction due to annular pancreas in the neonatal period, was referred to our hospital for further examination of chronic pancreatitis. Endoscopic retrograde cholangiopancreatography and magnetic resonance cholangiopancreatography revealed choledocholithiasis, pancreatic lithiasis, and pancreaticobiliary maljunction without biliary dilatation. Choledocholithotomy and cholecystectomy were performed, and highly elevated levels of amylase in bile from the common bile duct were found intraoperatively. Conclusion The present case highlights a possible association of pancreaticobiliary maljunction in a patient with annular pancreas.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pancreaticobiliary maljunction diagnosed long after laparotomy in the neonatal period for annular pancreas: report of a case

et al. 2019

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“…In 2005, we examined cholangiopancreatograms of 78 PBM patients and reported that biliary carcinoma was identified significantly less frequently in patients with dorsal pancreatic duct dominance, in which the maximum diameter of the Santorini duct was almost equal to or greater than that of the ventral pancreatic duct. Since the amylase levels in the bile were significantly lower with dorsal pancreatic duct dominance than with a normal pancreatic duct system in PBM patients, we suspected that most pancreatic juice in the upper dorsal pancreatic duct in PBM with dorsal pancreatic duct dominance is drained into the duodenum through the minor duodenal papilla .…”

Section: Introductionmentioning

confidence: 99%

Classification of pancreaticobiliary maljunction and its clinical features in adults

Yoshimoto

Kamisawa

Kikuyama

et al. 2019

J Hepato Biliary Pancreat

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Background In pancreaticobiliary maljunction (PBM), reflux of pancreatic juice and bile produces various pathological conditions in the biliary tract and pancreas. Clinical features according to the classification of PBM by confluence between the distal bile duct and the main pancreatic duct proposed in 2015 were evaluated in children. Methods Clinical features and complicating diseases according to the PBM classification were evaluated in 168 adult PBM patients. Patency of Santorini duct and associated biliary carcinomas were evaluated in 123 patients. Results Similar to children, there were significant differences in age (P < 0.01) and type of common bile duct (P < 0.01) between the groups of the classification. Unlike in children, there was no significant difference in the incidence of abdominal pain and hyperamylasemia. There were 87 associated biliary carcinomas (79 gallbladder carcinomas and eight cholangiocarcinomas). PBM patients with a cudgel‐type Santorini duct, which is greater than 2 mm in diameter, did not develop biliary carcinomas, compared to 61.1% of those with other types of Santorini duct (P < 0.01). Conclusions Clinical features according to the PBM classification in adults were different from those in children. Although biliary carcinomas were frequently seen in adult PBM patients, none of those with a cudgel‐type Santorini duct developed biliary carcinoma.

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Dorsal Pancreatic Duct Dominance in Pancreaticobiliary Maljunction

Cited by 2 publications

References 0 publications

Pancreaticobiliary maljunction diagnosed long after laparotomy in the neonatal period for annular pancreas: report of a case

Pancreaticobiliary maljunction diagnosed long after laparotomy in the neonatal period for annular pancreas: report of a case

Classification of pancreaticobiliary maljunction and its clinical features in adults

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