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Pancreaticobiliary Maljunction
Alexander J. Towbin, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Synonyms

              • Long common channel
            • Definitions

              • Pancreaticobiliary maljunction (PBM): Congenital malformation where pancreatic duct & common bile duct (CBD) join outside of duodenal wall
                • Long common channel allows pancreatic juices to reflux into biliary system
                • Chronic reflux of pancreatic juices leads to high risk of gallbladder or biliary cancer
              • High confluence of pancreaticobiliary ducts: Less severe variant defined by following criteria
                • Common channel length ≥ 6 mm
                • Communication between pancreatic duct & CBD occludes when sphincter of Oddi contracts

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    • Other Modality Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • Staging, Grading, & Classification

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Itokawa F et al: Exploring the length of the common channel of pancreaticobiliary maljunction on magnetic resonance cholangiopancreatography. J Hepatobiliary Pancreat Sci. 22(1):68-73, 2015
                                        2. Kamisawa T et al: Pancreaticobiliary maljunction and biliary cancer. J Gastroenterol. 50(3):273-9, 2015
                                        3. Sugita R: Pancreaticobiliary reflux as a high-risk factor for biliary malignancy: Clinical features and diagnostic advancements. World J Hepatol. 7(13):1735-41, 2015
                                        4. Kamisawa T et al: Diagnostic criteria for pancreaticobiliary maljunction 2013. J Hepatobiliary Pancreat Sci. 21(3):159-61, 2014
                                        5. Kamisawa T et al: Recent advances and problems in the management of pancreaticobiliary maljunction: feedback from the guidelines committee. J Hepatobiliary Pancreat Sci. 21(2):87-92, 2014
                                        6. Wang CL et al: Magnetic resonance cholangiopancreatography study of pancreaticobiliary maljunction and pancreaticobiliary diseases. World J Gastroenterol. 20(22):7005-10, 2014
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Pathology

                                                • Clinical Issues

                                                  TERMINOLOGY

                                                  • Synonyms

                                                    • Long common channel
                                                  • Definitions

                                                    • Pancreaticobiliary maljunction (PBM): Congenital malformation where pancreatic duct & common bile duct (CBD) join outside of duodenal wall
                                                      • Long common channel allows pancreatic juices to reflux into biliary system
                                                      • Chronic reflux of pancreatic juices leads to high risk of gallbladder or biliary cancer
                                                    • High confluence of pancreaticobiliary ducts: Less severe variant defined by following criteria
                                                      • Common channel length ≥ 6 mm
                                                      • Communication between pancreatic duct & CBD occludes when sphincter of Oddi contracts

                                                  IMAGING

                                                  • General Features

                                                    • CT Findings

                                                      • MR Findings

                                                        • Ultrasonographic Findings

                                                          • Other Modality Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • Staging, Grading, & Classification

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Itokawa F et al: Exploring the length of the common channel of pancreaticobiliary maljunction on magnetic resonance cholangiopancreatography. J Hepatobiliary Pancreat Sci. 22(1):68-73, 2015
                                                                              2. Kamisawa T et al: Pancreaticobiliary maljunction and biliary cancer. J Gastroenterol. 50(3):273-9, 2015
                                                                              3. Sugita R: Pancreaticobiliary reflux as a high-risk factor for biliary malignancy: Clinical features and diagnostic advancements. World J Hepatol. 7(13):1735-41, 2015
                                                                              4. Kamisawa T et al: Diagnostic criteria for pancreaticobiliary maljunction 2013. J Hepatobiliary Pancreat Sci. 21(3):159-61, 2014
                                                                              5. Kamisawa T et al: Recent advances and problems in the management of pancreaticobiliary maljunction: feedback from the guidelines committee. J Hepatobiliary Pancreat Sci. 21(2):87-92, 2014
                                                                              6. Wang CL et al: Magnetic resonance cholangiopancreatography study of pancreaticobiliary maljunction and pancreaticobiliary diseases. World J Gastroenterol. 20(22):7005-10, 2014