1979 Volume 21 Issue 2 Pages 170-177
The anomalous pancreaticobiliary ductal union in which a common bile duct terminates not in the duodenum but in a high position of pancreatic duct has recently been attracting attention in the relation to the congenital ditation of the biliary tract. In this study, 10 cases of the anomalous union capable of being diagnosed by means of the endoscopic retrograde pancreaticocholangiography have been investigated. The clinical symptoms, laboratory findings and x-ray findings in these cases are reported. Major clinical symptoms, 9 cases out of 10 cases, included upper abdominal pain and epigastric pain. The rise of serum alkaline phosphatase level was also observed frequently. The length of common channels examined by the x-ray was in the range of 15-30mm, the average was 19.1mm, The dilatation of common bile duct was detected in 8 cases out of 10 cases (80%), whereas the narrowing was observed in 1 case, which was suffered from the carcinoma of the extrahepatic biliary duct. Advanced dilatation, namely the diameter of common bile duct being more than 20mm, was seen in 5 cases out of the 8 cases, and only mild dilatation was observed in remaining 3 cases. On the basis of these findings, it was considered to be premature to indicate some correlation between the congenital dilatation of the biliary tract and the anomalous union of common bile duct. Further studies with more clinical cases are required to derive the conclusion and to establish effective therapeutic means.
