A Case of Anomalous Arrangement of Pancreaticobiliary Ductal System Treated with Cholecystectomy and Endoscopic Sphincteropapillotomy

• Published in: Nippon Shokaki Geka Gakkai zasshi Vol. 27; no. 7; pp. 1835 - 1838
• Main Authors: Sakai, Yoshiharu, Lin, Hitoshige, Nishimura, Kazuaki, Yamamoto, Yuzo, Ida, Kazuo, Hisano, Syouji
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society of Gastroenterological Surgery 1994
• Subjects: anomalous arrangement of panereaticobiliary ductal system; endoscopic sphincteropapillotomy
• ISSN: 0386-9768; 1348-9372
• DOI: 10.5833/jjgs.27.1835

A 68-year-old woman underwent cholecystectomy for gallstone. An anomalous arrangement of the pancreaticobiliary ductal system was suspected postoperatively from T-tube cholangiography, and was confirmed by endoscopic retrograde cholangiopancreatography. The length of the common duct was approximately 15mm. The common bile duct was not dilated but had two small diverticula. The amylase level in bile was measured before and after eating. The level rose remarkably after eating, indicating reflux of the pancreatic juice into the bile duct. Endoscopic sphincteropapillotomy (EST) was performed. The amylase level then remained in the normal range even after eating. It is suggested that EST could be one of the therapeutic modalities for anomalous arrangement of the pancreaticobiliary ductal system.