Sugiyama et al have formulated a rather comprehensive strategy for the management
of pancreatitis associated with an anomalous pancreaticobiliary junction (AJPBD) by
incorporating endoscopic sphincterotomy (ES).
1
They made no reference, however, to other relevant literature, which does exist.
2
,
3
,
4
,
5
Indeed, they have reaffirmed many of our observations. ES is an important adjunct
in the management of AJPBD associated with pancreatic ductal abnormalities. We extended
its application beyond that alluded to by the authors, including (1) minor papillotomy
for recurrent pancreatitis after excision of the choledochal cyst and transduodenal
sphincteroplasty; (2) ES and extraction of protein plugs from the dilated common channel
and the choledochal stump after incomplete choledochal cyst excision
2
; (3) ES followed by common bile duct (CBD) excision and side-to-side pancreaticojejunostomy
in patients with an irregular pancreatic duct with calculi in the pancreatic head.To read this article in full you will need to make a payment
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References
Sugiyama M, Atomi Y, Kuroda A. Pancreatic disorders associated with anomalous pancreaticobiliary junction.
- Long accessory hepatic duct associated with congenital dilation of the common bile duct.Am J Gastroenterol. 1993; 88: 619-621
- Emergent endoscopic therapy for anomalous pancreaticobiliary junction.J Pediatr Surg. 1993; 28: 1523-1524
- Endoscopic sphincterotomy in young patients with choledochal dilatation and a long common channel: a preliminary report.Br J Surg. 1992; 79: 550-552
- Clinical application of the study on the sphincter of Oddi motor activity in patients with anomalous pancreaticobiliary junction.Am J Gastroenterol. 1992; 87: 927
- Anomalous arrangement of the pancreaticobiliary ductal system without dilatation of the biliary tract.Surg Today. 1992; 22: 276-279
- Anomalous pancreaticobiliary junction without congenital choledochal cyst.Br J Surg. 1998; 85: 991-996
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© 2000 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
