Pancreaticobiliary maljunction (PBM): Congenital malformation where pancreatic duct & common bile duct (CBD) join outside of duodenal wall
Long common channel allows pancreatobiliary & biliopancreatic reflux
Chronic pancreatobiliary reflux leads to high risk of gallbladder & biliary cancer
Biliopancreatic reflux causes acute pancreatitis
2 types of PBM
PBM with congenital biliary dilation
PBM without congenital biliary dilation
Congenital biliary dilation
Previously referred to as type I or IVa choledochal cyst
Requires enlarged diameter of CBD + PBM
Definition for enlarged CBD depends on age
Age 0 years: > 3 mm
Age 5 years: > 3.9 mm
Age 10 years: > 4.5 mm
Age 15 years: > 5 mm
Age 20 years: > 5.9 mm
IMAGING
General Features
CT Findings
Ultrasonographic Findings
MR Findings
Other Modality Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
Staging, Grading, & Classification
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
Ono A et al: Imaging of pancreaticobiliary maljunction. Radiographics. 40(2):378-92, 2020
Kamisawa T et al: Pancreaticobiliary maljunction: markedly high risk for biliary cancer. Digestion. 99(2):123-5, 2019
Kamisawa T et al: Pancreaticobiliary maljunction and congenital biliary dilatation. Lancet Gastroenterol Hepatol. 2(8):610-8, 2017
Hamada Y et al: Diagnostic criteria for congenital biliary dilatation 2015. J Hepatobiliary Pancreat Sci. 23(6):342-6, 2016
Kamisawa T et al: Diagnostic criteria for pancreaticobiliary maljunction 2013. J Hepatobiliary Pancreat Sci. 21(3):159-61, 2014
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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References
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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
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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 pancreatobiliary & biliopancreatic reflux
Chronic pancreatobiliary reflux leads to high risk of gallbladder & biliary cancer
Biliopancreatic reflux causes acute pancreatitis
2 types of PBM
PBM with congenital biliary dilation
PBM without congenital biliary dilation
Congenital biliary dilation
Previously referred to as type I or IVa choledochal cyst
Requires enlarged diameter of CBD + PBM
Definition for enlarged CBD depends on age
Age 0 years: > 3 mm
Age 5 years: > 3.9 mm
Age 10 years: > 4.5 mm
Age 15 years: > 5 mm
Age 20 years: > 5.9 mm
IMAGING
General Features
CT Findings
Ultrasonographic Findings
MR Findings
Other Modality Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
Staging, Grading, & Classification
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
Ono A et al: Imaging of pancreaticobiliary maljunction. Radiographics. 40(2):378-92, 2020
Kamisawa T et al: Pancreaticobiliary maljunction: markedly high risk for biliary cancer. Digestion. 99(2):123-5, 2019
Kamisawa T et al: Pancreaticobiliary maljunction and congenital biliary dilatation. Lancet Gastroenterol Hepatol. 2(8):610-8, 2017
Hamada Y et al: Diagnostic criteria for congenital biliary dilatation 2015. J Hepatobiliary Pancreat Sci. 23(6):342-6, 2016
Kamisawa T et al: Diagnostic criteria for pancreaticobiliary maljunction 2013. J Hepatobiliary Pancreat Sci. 21(3):159-61, 2014
Wang CL et al: Magnetic resonance cholangiopancreatography study of pancreaticobiliary maljunction and pancreaticobiliary diseases. World J Gastroenterol. 20(22):7005-10, 2014
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