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: Terumi Kamisawa, Yuyang Tu, Hitoshi Nakajima, Naoto Egawa, Kouji Tsuruta, Atsutake Okamoto, Masakatsu Matsukawa
• Journal: Abdominal imaging (Abdom Imaging) 2007 May-Jun Vol. 32 Issue 3 Pg. 365-9 ISSN: 0942-8925 [Print] United States
• PMID: 16955378 (Publication Type: Journal Article)

Topics

• Acute Disease
• Bile Ducts (abnormalities, pathology)
• Cholangiopancreatography, Endoscopic Retrograde
• Humans
• Pancreatic Ducts (abnormalities, pathology)
• Pancreatitis (pathology, physiopathology)