Anomalous pancreaticobiliary junction

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An anomalous pancreaticobiliary junction, also known as pancreaticobiliary maljunction, describes the abnormal junction of the pancreatic duct and common bile duct that occurs outside the duodenal wall to form a long common channel (>15 mm).

Epidemiology

Associations

The anomalous junction is often associated with a choledochal cyst. The vast majority of patients with Todani type Ia, Ic, and IVa choledochal cysts have an anomalous pancreaticobiliary junction ². However, the anomalous junction can be present without a choledochal cyst.

Pathology

Classification

The Japanese Study Group on Pancreaticobiliary Maljunction (JSPBM) proposed the following classification:

type A (stenotic type): dilatation of the common bile duct upstream of a stenotic segment of distal common bile duct, which joins the common channel
type B (non‐stenotic type): nonstenotic distal common bile duct smoothly joins the common channel; no localized dilatation of the common channel
type C (dilated channel type): narrow distal common bile duct joins dilated common channel
type D (complex type): complex maljunction associated with annular pancreas, pancreas divisum, or other complicated duct systems

Treatment and prognosis

The anomaly is associated with a higher risk of acute pancreatitis, cholangitis, and biliary tract carcinoma (cholangiocarcinoma, gallbladder carcinoma) ^2,3.

Treatment is surgical correction.

-<p>An <strong>anomalous pancreaticobiliary junction</strong>, also known as <strong>pancreaticobiliary maljunction</strong>, describes the abnormal junction of the <a href="/articles/pancreatic-ducts">pancreatic duct</a> and <a href="/articles/common-bile-duct">common bile duct</a> that occurs outside the <a href="/articles/duodenum">duodenal</a> wall to form a long common channel (>15 mm).</p><h4>Epidemiology</h4><h5>Associations</h5><p>The anomalous junction is often associated with a <a href="/articles/choledochal-cyst">choledochal cyst</a>. The vast majority of patients with <a href="/articles/todani-classification-of-bile-duct-cysts">Todani</a> type Ia, Ic, and IVa choledochal cysts have an anomalous pancreaticobiliary junction <sup>2</sup>. However, the anomalous junction can be present without a choledochal cyst.</p><h4>Pathology</h4><h5>Classification</h5><p>The Japanese Study Group on Pancreaticobiliary Maljunction (JSPBM) proposed the following classification:</p><ul>
+<p>An <strong>anomalous pancreaticobiliary junction</strong>, also known as <strong>pancreaticobiliary maljunction</strong>, describes the abnormal junction of the <a href="/articles/pancreatic-ducts">pancreatic duct</a> and <a href="/articles/common-bile-duct">common bile duct</a> that occurs outside the <a href="/articles/duodenum">duodenal</a> wall to form a long common channel (>15 mm).</p><p>Epidemiology</p><p>Associations</p><p>The anomalous junction is often associated with a <a href="/articles/choledochal-cyst">choledochal cyst</a>. The vast majority of patients with <a href="/articles/todani-classification-of-bile-duct-cysts">Todani</a> type Ia, Ic, and IVa choledochal cysts have an anomalous pancreaticobiliary junction <sup>2</sup>. However, the anomalous junction can be present without a choledochal cyst.</p><p>Pathology</p><p>Classification</p><p>The Japanese Study Group on Pancreaticobiliary Maljunction (JSPBM) proposed the following classification:</p><ul>
-</ul><h4>Treatment and prognosis</h4><p>The anomaly is associated with a higher risk of <a href="/articles/acute-pancreatitis">acute pancreatitis</a>, <a href="/articles/cholangitis">cholangitis</a>, and biliary tract carcinoma (<a href="/articles/cholangiocarcinoma">cholangiocarcinoma</a>, <a href="/articles/gallbladder-carcinoma-1">gallbladder carcinoma</a>) <sup>2,3</sup>.</p><p>Treatment is surgical correction.</p>
+</ul><p>Treatment and prognosis</p><p>The anomaly is associated with a higher risk of <a href="/articles/acute-pancreatitis">acute pancreatitis</a>, <a href="/articles/cholangitis">cholangitis</a>, and biliary tract carcinoma (<a href="/articles/cholangiocarcinoma">cholangiocarcinoma</a>, <a href="/articles/gallbladder-carcinoma-1">gallbladder carcinoma</a>) <sup>2,3</sup>.</p><p>Treatment is surgical correction.</p>

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Anomalous pancreaticobiliary junction

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