Strategies for diagnosis and treatment of anomalous junction of pancreaticobiliary duct complicated by acute pancreatitis and literature review

Abstract

Objective To explore the strategies for diagnosis and treatment of anomalous junction of pancreaticobiliary duct (AJPBD) complicated by acute pancreatitis. Methods The clinical dataof 22 patients with abnormal pancreaticobiliary junction were analyzed retrospectively. Results The incidence of acute pancreatitis in this series was 31.8 % (7/22), thereinto, 5 cases(71.4%) in C-Ptype (the common bile duct joining the pancreatic duct) and 2(28.6%) in P-C type (the pancreatic duct joining the common bile duct). Seven patients underwent ERCP+ EST+ ENBD. Two patients with common bile duct stones were treated with stone basket and cholecystectomy was performed in two cases with gallstone. All patients were successfully treated. The follow-up for l year showed that there was no recurrence of pancreatitis. Conclusion Acute pancreatitis usually occurs in patients with AJPBD, especially in C-P type or with gallbladder stone or common bile duct stone. ERCP+EST+ENBD and prophylactic cholecystectomy are effective to prevent and treat acute pancreatitis. Key words: Pancreatitis; Anomalous junction of pancreaticobiliary duct; Endoscopic retrograde cholangiopancreatography; Cholecystectomy