Usefulness of intraductal ultrasonography (IDUS) for the diagnosis of pancreaticobiliary maljunction without dilatation of the bile duct

• Published in: Tando Vol. 21; no. 4; pp. 489 - 496
• Main Authors: Kagaya, Hirobumi, Utsumi, Kiyoshi, Onodera, Hiroyoshi, Kayaba, Yoshiro, Suzuki, Shinichi, Suzuki, Masaki, Kikuchi, Tohru, Noguchi, Tetsuya
• Format: Journal Article
• Language: Japanese
• Published: Japan Biliary Association 2007
• Subjects: bile duct cancer; common channel; gallbladder cancer; intraductal ultrasonography (IDUS); pancreaticobiliary maljunction; 共通管; 管腔内超音波検査法(IDUS); 胆嚢癌; 胆管癌; 胆管非拡張型膵胆管合流異常
• ISSN: 0914-0077; 1883-6879
• DOI: 10.11210/tando1987.21.4_489

We experienced 32 patients of pancreaticobiliary maljunction without dilatation of the bile duct in 10 years.23 out of 32 patients (71.9%) were diagnosed by ERCP. The other 9 patients (28.1%) were diagnosed only by IDUS, not by ERCP. Malignant changes in the gallbladder was observed in 10 of the 32 patients (31.3%), and the bile duct cancer was seen in 4 patients (12.4%). In 2 cases of gallbladder cancer and 2 of bile duct cancer, maljunction was newly identified by retrospective review of the video tapes of IDUS. In these cases, the length of the commom channel was shorter, and the diameter was thinner than those of the cases diagnosed by ERCP. There is a possibility that quite a few cases with pancreaticobiliary maljunction are not recognized officially. Therefore IDUS should be performed in cases with suspicion by ERCP, cancer of biliary tract, or mucosal thickness of gallbladder, as many as possible to pick up the latent maljunction.