Anomalous pancreaticobiliary junction

Dr Francis Deng and Radswiki et al.

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).

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.

The Japanese Study Group on Pancreaticobiliary Maljunction 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

The anomaly is associated with a higher risk of acute pancreatitis, cholangitis, and biliary tract carcinoma (cholangiocarcinoma, gallbladder carcinoma2,3.

Treatment is surgical correction.

Anatomy: Abdominopelvic

Anatomy: Abdominopelvic

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Article information

rID: 12630
Synonyms or Alternate Spellings:
  • Pancreaticobiliary maljunction

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