Pathophysiology and treatment strategy for congenital biliary dilatation and pancreaticobiliary maljunction

DOI
  • Mori Yasuhisa
    Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health
  • Shibao Kazunori
    Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health
  • Kohi Shiro
    Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health
  • Oba Takuya
    Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health
  • Tamura Toshihisa
    Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health
  • Sato Norihiro
    Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health
  • Hirata Keiji
    Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health

Bibliographic Information

Other Title
  • 先天性胆道拡張症と膵・胆管合流異常の病態と治療

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Description

<p>Pancreaticobiliary maljunction is a congenital malformation in which the pancreatic and bile ducts join anatomically outside the duodenal wall. This malformation is classified into a dilated bile duct type (congenital biliary dilatation) and a non-dilated bile duct type. Pancreaticobiliary maljunction causes pancreatic juice to reflux into the bile duct, causing inflammation, duct dilatation, and the possibility of malignant transformation; therefore, surgery is indicated. Surgical management for congenital biliary dilatation comprises bile duct resection with cholecystectomy followed by biliary reconstruction, and the management for the non-dilated type of pancreaticobiliary maljunction is prophylactic cholecystectomy. Insurance reimbursements have covered laparoscopic surgery for congenital biliary dilatation since 2016 and robot-assisted surgery since 2022 in Japan. Careful long-term postoperative follow-up in both diseases is necessary to identify cholangiocarcinogenesis of the remnant bile duct.</p>

Journal

  • Tando

    Tando 36 (5), 599-609, 2022-12-31

    Japan Biliary Association

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