Pancreaticobiliary malunion and incomplete pancreas divisum: an unusual cause of common bile duct obstruction

Petrášek, Jan; Hucl, Tomáš; Spicák, J

doi:10.2478/v10039-008-0002-3

Cited by 3 publications

(2 citation statements)

References 24 publications

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“…[5,6] Absence of a sphincter at the pancreatobiliary junction allows regurgitation of pancreatic juice and results in cystic lesions of bile duct. [4] A similar hypothesis of a significant reflux of pancreatic juice to the bile duct can explain the association of choledochal cyst with pancreas divisum. Cystic bile duct anomalies require treatment due to 2 major reasons: Þ rst, the pain or recurrent episodes of cholangitis and pancreatitis; second, the malignant potency with a high risk of developing cystic adenocarcinoma of the bile duct.…”

Section: Discussionmentioning

confidence: 92%

“…It has been proposed that this anatomic variant promotes reß ux of pancreatic juice into the common bile duct, resulting in inß ammation, weakening of the bile duct wall and dilatation. [4] Pancreatobiliary malunion is a congenital anomaly in which the junction of the pancreatic and biliary ducts located outside the duodenal wall, giving rise to a long common pancreatobiliary channel with a high risk of biliary tract carcinoma. [5,6] Absence of a sphincter at the pancreatobiliary junction allows regurgitation of pancreatic juice and results in cystic lesions of bile duct.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Pancreas divisum and choledochal cyst

Sarangapani¹,

Balamurali²,

Pugazhendhi³

et al. 2009

Indian J Med Sci

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Pancreas divisum and choledochal cyst

Sarangapani¹,

Balamurali²,

Pugazhendhi³

et al. 2009

Indian J Med Sci

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A study on the human pancreaticobiliary duct system and ampulla region with their clinical considerations

Prasanna

D’Souza

Rajagopal

et al. 2015

Indian J Gastroenterol

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Risk Factors for Postoperative Stone Formation in Pediatric Choledochal Cysts: A Study of 457 Cases

Gang,

Kim,

Kwon

et al. 2024

Preprint

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Background: Postoperative bile duct stones, including intrahepatic bile duct (IHD) stones and remnant distal common bile duct (remnant intrapancreatic common bile duct, RIPD) or common channel duct (CCD) stones, cause long-term complications following choledochal cyst excision. We aimed to retrospectively review occurrence, associated factors, and treatment of postoperative bile duct stones. Methods: Records of 457 pediatric patients who underwent choledochal cyst excision at Asan Medical Center (1992-2021) were retrospectively reviewed. Data on cholelithiasis, operation, and outcomes were analyzed. Results: Overall, 457 pediatric patients underwent choledochal cyst excision, with 21 developing intrahepatic duct (IHD) stones, primarily associated with Todani type IVa cysts, especially Tsuchida types 2 or 3, which are often linked to IHD dilation and upstream stenosis. Patients with RIPD/CCD stones were all identified with complicated Komi types, and the impact of pancreas divisum itself was unclear. Early surgery even before six months of age is associated with improved prognosis regarding the occurrence of IHD stones, but not related with RIPD/CCD stones. Early surgery even before six months of age is associated with improved prognosis regarding the occurrence of IHD stones, but not related with RIPD/CCD stones. Conclusions: This is the largest retrospective study comprising 21 IHD and 18 RIPD/CCD stones from 457 pediatric patients with choledochal cysts and including 21 cases of IHD stones and 18 cases of RIPD/CCD stones as well as their clinical and treatment outcomes to date in this aspect. Our findings suggest that a more systematic and long-term follow-up is needed for patients with choledochal cysts CC postoperatively.

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Pancreaticobiliary malunion and incomplete pancreas divisum: an unusual cause of common bile duct obstruction

Cited by 3 publications

References 24 publications

Pancreas divisum and choledochal cyst

Pancreas divisum and choledochal cyst

A study on the human pancreaticobiliary duct system and ampulla region with their clinical considerations

Risk Factors for Postoperative Stone Formation in Pediatric Choledochal Cysts: A Study of 457 Cases

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