Abstract
A woman in her fifties with a history of upper abdominal pain and elevation of both hepatobiliary and pancreatic enzymes was admitted to our hospital. Magnetic resonance cholangiopancreatography showed a notch-like constriction of the lower bile duct without bile duct dilatation. Endoscopic retrograde cholangiopancreatography from the papilla of Vater revealed a slightly swollen common channel, including a small defect and a short ventral pancreatic duct. Pancreatography from the minor papilla revealed a dorsal pancreatic duct not connected to the ventral duct. Intraductal ultrasonography of the bile duct demonstrated a septum in the common channel and sludge in the middle bile duct. Based on the findings, the patient was diagnosed as having complete pancreas divisum and pancreaticobiliary maljunction without bile duct dilatation, with a septum in the common channel. Extrahepatic bile duct resection and cholecystectomy were performed. Histopathological examination revealed no evidence of malignancy in either the gallbladder or the bile duct mucosa. Further accumulation of cases and long-term follow-up are required.
