Endoscopic Diagnosis And Treatment Of Pancreaticobiliary Maljunction

Objective To evaluate the relevance ratio、 typing characteristics,related-pancreaticobiliary diseases and endoscopic treatment of pancreaticobiliarymaljunction（PBM）.Methods Retrospective analysis for370cases from January2009to December2012whoes bile duct and pancreatic duct are both developed by endoscopicretrograde pancreatic angiography (ERCP) or Preoperative magnetic resonanceimaging of pancreatic (magnetic resonance cholangio-pancreato graphy, MRCP)examination.All patients of pancreaticobiliary maljunction should be distinguished thesub-type of PBM.According to each patient’sub-type and related-pancreaticobiliarydiseases,selected appropriate endoscopic method for its treatment before surgery,suchas stone extraction,expansion or stent drainage and so on.Results（1）Relevance ratio For the past four years，cases of PBM were diagnosedin24，the relevance ratio of PBM was6.49%。（2）Gender and age The PBM patients a total of24cases, of which the male8cases, female16cases, male to female ratio1:2; Children in3cases, adults in21cases, age2-82years old, average42.67±18.34years old.（3）Classified Among them,Type I was seen in11patiens,typeⅡin12,typeⅢ in1.(4) Related-pancreaticobiliary diseases Combined with Chole dochal Cyst(CC) in10cases,bile duct cancer in1case,bile duct stones in15cases,pancreatic ductstones in1case, pancreatitis in5cases,pancreas divisum in1cases.(5) Endoscopic therapy There are13cases underwent endoscopic bile ductstone extracted successfully，and1case of pancreatic duct stone extracted.The otherendoscopic treatments applied in patients included biliary stent drainage in8cases，nasal biliary drainage in6cases,self-expanding biliary metal stent placement in1 case，and pancreatic stent placement in5cases.Conclusion Pancreaticobiliary maljunction(PBM) is a rare congenital anomaly,witch have a close relationship With some pancreaticobiliary diseases. ERCP inaddition to provide relatively objective anatomy basis for PBM, it can treatment PBMrelated-pancreaticobiliary diseases such as biliary calculi, Biliary stricture,pancreatolithiasis and so on. whether ERCP therapy can instead of surgery to changeor improve pancreatic bile flow dynamic disorder or not remains to be discussed.