STUDY ON THE FORM OF THE TERMINAL PORTION OF BILE DUCT AND PANCREATIC DUCT IN CONGENITAL BILIARY DILATATION

Abstract

Relationship between pancreatic and bile duct was analysed in eleven cases with congenital biliacy dilatation diagnosed by ERCP, especially in regard to the types in confluenting bile duct with pancreatic duct and the forms of their terminal portion.
Generally, the author could classify 5 categories (Type I-Type V) in the type of their confluence.Abnormality in the type of confluence was disclosed (Type IV or Type V) in eight cases (73%). Both type were characterized by two findings. One was the stricture of the terminal portion of bile duct, at the point just over the junction with pancreatic duct. And another was the prolongation of the common channel.
Depending upon the type of their confluence, following abnormal features were disclosed. In Type IV in which bile duct joined into pancreatic duct, a defect of the notch at the opening of pancreatic duct was found. In Type V in which bile duct joined into pancreatic duct, a dilatation of pancreatic duct in its head portion was seen.
Our results suggest that both congenital and acquired factors are concerned with the pathogenetic mechanism of congenital biliary dilatation.
That is, the type of abnomality in confluenting bile duct with pancreatic duct and the reflux of pancreatic juice into bile duct would contribute to developing biliary dilatation in the disease.