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Gross dissection and radiological studies of abnormal pancreatico‐choledocho‐ductal junction
Author(s) -
Shiotsu Hidetoshi,
Suda Koichi,
Matsumoto Yoshiro,
Miyano Takeshi
Publication year - 1994
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/bf02391071
Subject(s) - medicine , common bile duct , pancreatic duct , radiology , pancreatic carcinoma , pancreas , dissection (medical) , pancreatic cancer , radiological weapon , carcinoma , cancer
The reliability of radiological diagnosis of abnormal pancreatico‐choledocho‐ductal junction (APCDJ) in comparison with findings of gross dissection of the pancreatic choledocho‐ductal junction was studied in 8 patients, based on comparison between radiologic and macroscopic findings of the junction in 99 patients who had received pancreatoduodenectomy. APCDJ, that is the joining of the common bile duct and the pancreatic duct in the pancreatic parenchyma extraduodenally, was identified in 5 patients both radiologically and macroscopically. Macroscopically, the length of their common channel ranged from 20 to 32 mm. with a mean of 29 mm. In the other three patients, APCDJ was misdiagnosed radiologically, for the following reasons. In a patient with pancreatic carcinoma, a rather long common channel, 15 mm in length, while ran in the submucosal layer of the duodenum, was though to be APCDJ on radiologic examinations. In a patient with bile duct carcinoma, an abnormal closing between the common bile duct and the pancreatic duct due to carcinomatous infiltration of the pancreas led to a radiologication misinterpretation for APCDJ. In the last patient, APCDJ was identified only macroscopically, not radiologically, because of a relatively short common channel and the location of common bile duct carcinoma. Thus, APCDJ was clearly identified in patients with a long common channel, whereas it was difficult to identify in patients with a short common channel.