Pancreas divisum in pancreaticobiliary maljunction.

Background/aims: Pancreaticobiliary maljunction (PBM) and pancreas divisum (PD) are congenital anomalies that develop in the embryo at an early stage. They are possibly the result of bile and pancreatic duct misarrangement. We investigated the configuration of the pancreatic duct in patients with PBM and its clinical implications.

Possibility of diagnosing early-stage chronic pancreatitis by endoscopic retrograde pancreatography.

Background: It has been proposed that pathological lesions in chronic pancreatitis initially arise in the acini or fine ducts of the pancreas. To investigate the possibility of diagnosing early-stage chronic pancreatitis by endoscopic retrograde pancreatography (ERP), we reviewed pancreatographic findings of the pancreatic duct branches in patients with chronic pancreatitis.

Methods: A total of 90 cases of chronic pancreatitis (calcified, n=52; noncalcified, n=38) were reassessed according to the imaging of the pancreatic duct branches by ERP.

Biliary carcinoma risk in patients with pancreaticobiliary maljunction and the degree of extrahepatic bile duct dilatation.

Background/aims: Pancreaticobiliary maljunction (PBM) carries a high risk of biliary carcinoma. This study aimed to examine the biliary complications of patients with PBM in relation to the degree of extra-hepatic bile duct dilatation.

Methodology: Ninety-eight cases of PBM could be divided into 5 groups according to the maximum diameter of the extrahepatic bile duct: < or = 10mm, 11-15mm, 16-20mm, 21-30mm, > or = 31mm.

Acute pancreatitis and a long common channel.

Background: As sphincter action does not functionally affect the union in pancreaticobiliary maljunction (PBM), two-way regurgitation occurs. We investigated the features of acute pancreatitis associated with patients displaying a long common channel.

Methods: We reviewed 3210 endoscopic retrograde cholangiopancreatograms.

Chronic pancreatitis progressing from segmental lesions.

Background/aims: Chronic pancreatitis is histologically and functionally a progressive disease. To examine the natural history of chronic pancreatitis, we evaluated serial pancreatography in cases of chronic pancreatitis, focusing on the progression of diffuse-type chronic pancreatitis from the segmental type.

Methodology: We reviewed 57 patients with chronic pancreatitis who had undergone endoscopic retrograde pancreatography on more than 2 occasions at intervals of at least 1 year.

Autoimmune pancreatitis associated with retroperitoneal fibrosis.

Context: Autoimmune pancreatitis is sometimes associated with other autoimmune diseases. We have presented two cases of autoimmune pancreatitis with retroperitoneal fibrosis and compared our findings with those found in the literature. CASE 1: A 71-year-old male developed anorexia and weight loss.

Classification of choledochocele.

Background/aims: Choledochocele is a rare abnormality of cystic or diverticular dilatation of the terminal intramural portion of the common bile duct. Because its anatomic form does not fit the criteria for pancreaticobiliary maljunction, reflux of bile or pancreatic juice has not been discussed in relation to choledochocele. Considering the flow of bile and pancreatic juice, the authors developed a new classification of choledochocele, and investigated associated pancreaticobiliary diseases.

Dorsal pancreatic duct dominance in pancreaticobiliary maljunction.

Objectives: In patients with pancreaticobiliary maljunction (PBM), reflux of pancreatic juice to the bile duct may contribute to carcinogenesis of the biliary tract. This study aimed to investigate the pancreatographic findings in patients with PBM and the relationship to their clinical findings in view of pancreatic juice flow.

Methods: Seventy-eight cholangiopancreatograms were reviewed.

Pancreatitis associated with pancreaticobiliary maljunction.

Background/aims: Pancreaticobiliary maljunction is a rare anomaly, but causes various pathological conditions in the biliary tract and the pancreas. This study aims at clarifying the features of pancreatitis associated with pancreaticobiliary maljunction.

Methodology: A total of 100 patients with pancreaticobiliary maljunction were reviewed.

Pancreatic endocrine and exocrine function and salivary gland function in autoimmune pancreatitis before and after steroid therapy.

Introduction: Autoimmune pancreatitis (AIP) is a distinct clinical entity in which an autoimmune mechanism may be involved in pathogenesis.

Aim: To investigate salivary gland function in addition to pancreatic endocrine and exocrine function in patients with AIP, and to determine changes occurring after steroid therapy.

Methodology: Fasting serum glucose levels, oral glucose tolerance tests or glycosylated hemoglobin values were examined in 19 patients with AIP.