Sonographic demonstration of wall thickness of the gallbladder in pediatric patients with pancreatico-biliary maljunction.

Background: Sonographic demonstration of extramural and intrapancreatic junction of the pancreatic and bile ducts, pathognomonic for pancreatico-biliary maljunction (PBM), is not easy in pediatric patients. We measured sonographic thickness of the gallbladder (GB) and retrospectively examined correlation of it with PBM.

Methods: Twenty-seven children with PBM were examined with conventional ultrasonography (US). All patients underwent hepaticojejunostomy, and resected GB were studied in histological examination. Preoperative extracorporeal US measured gallbladder wall thickness, and abnormal GB wall was defined 3 mm or more in thickness.

Results: They consisted of 8 males and 19 females, ranging in age from 2 months to 11 years. The thickness of the GB wall was more than 3 mm in 18: 10 with smooth thickness and 8 with non-uniform thickness. The thickness of GB wall was found in 16 (84.2%) of the 19 patients more than 1 year of age. The difference between sonographic and macroscopic measurements of the wall thickness was less than 1 mm in 24 (89%) of the 27 patients.

Conclusion: US measurement of gallbladder wall thickness can be a screening test more than 1 year of age for PBM.