2010 Volume 24 Issue 1 Pages 65-72
Purpose: To investigate an appropriate treatment strategy for patients with non-dilated bile duct of pancreaticobiliary maljunction (PBM) through an evaluation of pancreaticobiliary reflux using secretin-stimulated MRCP.
Patients: Six patients with non-dilated bile duct of PBM.
Methods: MPCP images were obtained every minute over a 15-minute period after secretin stimulation. The sequential morphological changes in the gallbladder, extrahepatic bile duct, and duodenum were assessed, and the total pixel values and intensity ratios of these organs were measured for each image.
Results: An increase in the intensity of the gallbladder was prominent and was maintained at a high level. Although an increase in the intensity of the bile duct was also observed, the total pixel value of the bile duct was less than that of the gallbladder. One year after cholecystectomy, reflux into the extra-hepatic bile duct was still observed, showing almost the same changes previously observed.
Conclusion: In cases of non-dilated bile duct of PBM, the gallbladder should be excised. It is, however, still controversial as to whether the extra-hepatic bile duct should be excised or not. Even if the bile duct is preserved, long-term observation is crucial.
