Abstract
A fourteen monthes old girl with congenital biliary dilatation initially presenting pancreatit is was reported. The operative cholangiogram via gallbladder demonstrated a very characteristic feature, massive reflux of the rediopaque dye into the pancreatic duct without visualization of the common channel and the duodenum. The patient progressed in satisfactory condition after hepaticojejunostomy (R-Y) after division of the communication between the common bile duct and the pancreatic duct. The choledocho-pancreatic end-to-side ductal anastomosis was successfully performed in 35 puppies as an experimental animal model of the choledocho-pancreatic long common channel disorders. This animal model was considered to be the most similar model to the human pathological disorders. In autopsy specimens, two of 35 puppies showed the most remarkable histologic changes of the pancreatic periductal parenchyma with dilatation of the pancreatic duct. Further-more in these cases, the choledocho-pancreatic ductal junction (anastomotic site) revealed special anatomical condition which the massive bile reflux into the pancreatic duct easily occured. These clinical and experimental results may suggest that the case of congenital biliary dilatation presenting pancreatitis has a special anatomical condition of the choledocho-pancreatic ductal junction which may permit massive reflux of the bile into the pancreatic duct.
