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Congenital pancreaticobiliary anomalies in an urban medical center in the United States

BACKGROUND AND AIM: Pancreaticobiliary anomalies are rare and often present with cryptic signs and symptoms, thus delaying appropriate treatment. METHODS: Endoscopic retrograde cholangiopancreatography (ERCP) was used to define pancreaticobiliary anomalies. A retrospective review was performed of 55...

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Autores principales: Sugawa, Choichi, Culver, Ashley, Sundaresan, Naresh, Lucas, Charles E
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wiley Publishing Asia Pty Ltd 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7731818/
https://www.ncbi.nlm.nih.gov/pubmed/33319053
http://dx.doi.org/10.1002/jgh3.12418
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author Sugawa, Choichi
Culver, Ashley
Sundaresan, Naresh
Lucas, Charles E
author_facet Sugawa, Choichi
Culver, Ashley
Sundaresan, Naresh
Lucas, Charles E
author_sort Sugawa, Choichi
collection PubMed
description BACKGROUND AND AIM: Pancreaticobiliary anomalies are rare and often present with cryptic signs and symptoms, thus delaying appropriate treatment. METHODS: Endoscopic retrograde cholangiopancreatography (ERCP) was used to define pancreaticobiliary anomalies. A retrospective review was performed of 5522 ERCPs conducted at a tertiary care center from 1972 to 2015. RESULTS: There were 249 (4.5%) patients with pancreaticobiliary anomalies, including 179 patients with pancreas divisum (PD), 44 patients with choledochal cyst (CC) (Todani's classification Type I: extrahepatic cyst 31, Type III; choledochocele 9, Type V: Caroli's disease 4), 20 patients with anomalous pancreaticobiliary ductal union (APDU), and 6 patients with other abnormalities. Of 179 patients with pancreas divisum, 8 (4.5%) required minor sphincterotomies for multiple unexplained acute pancreatitis. Of the 31, 15 (48%) Type I CC patients underwent an operation. In patients with Type III CC (choledochocele), seven of the nine were treated by endoscopic sphincterotomy, and two patients were treated by surgery. Four patients with Type V CC (Caroli's disease) were managed nonoperatively. Of the 20 patients with APDU, 8 (40%) required operative intervention. Six patients were found to have other anomalies: two with pancreas bifidum, one with a duplication of the gallbladder, one with a cystic duct diverticulum, one with an annular pancreas, and one with an abnormal cystic duct origin. These patients were treated based on their etiology. CONCLUSION: Pancreaticobiliary anomalies are rare and can be defined using ERCP. The appreciation of these abnormalities is important for the proper diagnosis and treatment of these rare biliary and pancreatic disorders.
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spelling pubmed-77318182020-12-13 Congenital pancreaticobiliary anomalies in an urban medical center in the United States Sugawa, Choichi Culver, Ashley Sundaresan, Naresh Lucas, Charles E JGH Open Original Articles BACKGROUND AND AIM: Pancreaticobiliary anomalies are rare and often present with cryptic signs and symptoms, thus delaying appropriate treatment. METHODS: Endoscopic retrograde cholangiopancreatography (ERCP) was used to define pancreaticobiliary anomalies. A retrospective review was performed of 5522 ERCPs conducted at a tertiary care center from 1972 to 2015. RESULTS: There were 249 (4.5%) patients with pancreaticobiliary anomalies, including 179 patients with pancreas divisum (PD), 44 patients with choledochal cyst (CC) (Todani's classification Type I: extrahepatic cyst 31, Type III; choledochocele 9, Type V: Caroli's disease 4), 20 patients with anomalous pancreaticobiliary ductal union (APDU), and 6 patients with other abnormalities. Of 179 patients with pancreas divisum, 8 (4.5%) required minor sphincterotomies for multiple unexplained acute pancreatitis. Of the 31, 15 (48%) Type I CC patients underwent an operation. In patients with Type III CC (choledochocele), seven of the nine were treated by endoscopic sphincterotomy, and two patients were treated by surgery. Four patients with Type V CC (Caroli's disease) were managed nonoperatively. Of the 20 patients with APDU, 8 (40%) required operative intervention. Six patients were found to have other anomalies: two with pancreas bifidum, one with a duplication of the gallbladder, one with a cystic duct diverticulum, one with an annular pancreas, and one with an abnormal cystic duct origin. These patients were treated based on their etiology. CONCLUSION: Pancreaticobiliary anomalies are rare and can be defined using ERCP. The appreciation of these abnormalities is important for the proper diagnosis and treatment of these rare biliary and pancreatic disorders. Wiley Publishing Asia Pty Ltd 2020-10-15 /pmc/articles/PMC7731818/ /pubmed/33319053 http://dx.doi.org/10.1002/jgh3.12418 Text en © 2020 The Authors. JGH Open: An open access journal of gastroenterology and hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Sugawa, Choichi
Culver, Ashley
Sundaresan, Naresh
Lucas, Charles E
Congenital pancreaticobiliary anomalies in an urban medical center in the United States
title Congenital pancreaticobiliary anomalies in an urban medical center in the United States
title_full Congenital pancreaticobiliary anomalies in an urban medical center in the United States
title_fullStr Congenital pancreaticobiliary anomalies in an urban medical center in the United States
title_full_unstemmed Congenital pancreaticobiliary anomalies in an urban medical center in the United States
title_short Congenital pancreaticobiliary anomalies in an urban medical center in the United States
title_sort congenital pancreaticobiliary anomalies in an urban medical center in the united states
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7731818/
https://www.ncbi.nlm.nih.gov/pubmed/33319053
http://dx.doi.org/10.1002/jgh3.12418
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