胆管拡張症における膵胆管合流異常の意義

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  • The Significance of Anomalous Pancreatico-biliary Ductal Junction in Choledochal Dilatation
  • タンカン カクチョウショウ ニ オケル スイ タンカン ゴウリュウ イジョウ

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We have treated 32 patients of choledochal dilatation during a period from 1966 to 1979. Nine were male and 23 female. Thirty one were operated. Sixteen had anomalous pancreatico-biliary ductal junction. According to the form of the common bile duct and the junction of pancreatico-biliary ductal system, these 16 cases were classified three types ; Type 1 ; cylindrical dilatation, which had a stenosis at the junction of pancreatico-biliary ductal system. Type 2 ; fusiform dilatation, which had a long common channel. Type 3 ; cystic dilatation, in which the bile duct connected to the pancreatic duct. In cases of type 1, a new etiological consideration, the over rotation theory of the ventral pancreas was suggested from the evidence of intra panceatic anastmosis between the common bile duct and the dorsal pancreatic duct in the early antenatal periods. We also concluded that the detection of anomalous pancreatico-biliary ductal junction is based on one of following criterias and clinical symptoms. 1. Radiological finding of the bile duct to open into the pancreatic duct. 2. Stenosis of the common bile dudt at the junction of the pancreatic duct. 3. Evidence of dilated common bile duct or abnormal high amylase levels in the bile in cases with a long common channel.

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