Embryological etiology of pancreaticobiliary system predicted from pancreaticobiliary maljunction with incomplete pancreatic divisum: a case report
Abstract Background The genesis of the “complex type” classification of pancreaticobiliary maljunction (PBM) is unclear, and the pancreaticobiliary anatomy is also varied according to each case. We encountered a patient with PBM and incomplete pancreatic divisum (PD). We herein discussed about the e...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2018-08-01
|
| Series: | BMC Surgery |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12893-018-0385-4 |
| _version_ | 1818536900684677120 |
|---|---|
| author | Yukihiro Sanada Yasunaru Sakuma Naohiro Sata |
| author_facet | Yukihiro Sanada Yasunaru Sakuma Naohiro Sata |
| author_sort | Yukihiro Sanada |
| collection | DOAJ |
| description | Abstract Background The genesis of the “complex type” classification of pancreaticobiliary maljunction (PBM) is unclear, and the pancreaticobiliary anatomy is also varied according to each case. We encountered a patient with PBM and incomplete pancreatic divisum (PD). We herein discussed about the embryological etiology of pancreaticobiliary system predicted from PBM with incomplete PD. Case presentation A 67-year-old man was found to have a dilatation of the common bile duct (CBD) during a medical examination at 62 years of age. The dilatation of the CBD subsequently progressed, and he was admitted to our hospital for surgical treatment. Magnetic resonance cholangiopancreatography revealed a dilatation from the common hepatic duct to the middle bile duct with PBM. Endoscopic retrograde cholangiopancreatography from the papilla of Vater revealed the pancreatic main duct via the pancreatic branch duct, and PBM with dilatation of the CBD and incomplete PD were revealed. We performed an extrahepatic bile duct resection and hepaticojejunostomy because of high risk of malignant transformation. Taping and transection of the bile duct without dilatation on the pancreatic side were performed, and thereafter, two orifices of the common channel and ventral pancreatic duct were ligated. The level of amylase in the bile was 7217 IU/L, and a histological examination of the CBD showed an inflammatory change of CBD, not a malignant transformation. Conclusion It is somewhat easy to identify the pancreatobiliary anatomy when the cause of embryology of both PBM and PD is thought to be an abnormal embryology of the ventral pancreas. |
| first_indexed | 2024-12-11T18:43:53Z |
| format | Article |
| id | doaj.art-fa9a6777b0304bb49365cf642977743a |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-12-11T18:43:53Z |
| publishDate | 2018-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-fa9a6777b0304bb49365cf642977743a2022-12-22T00:54:32ZengBMCBMC Surgery1471-24822018-08-011811410.1186/s12893-018-0385-4Embryological etiology of pancreaticobiliary system predicted from pancreaticobiliary maljunction with incomplete pancreatic divisum: a case reportYukihiro Sanada0Yasunaru Sakuma1Naohiro Sata2Department of Surgery, Jichi Medical UniversityDepartment of Surgery, Jichi Medical UniversityDepartment of Surgery, Jichi Medical UniversityAbstract Background The genesis of the “complex type” classification of pancreaticobiliary maljunction (PBM) is unclear, and the pancreaticobiliary anatomy is also varied according to each case. We encountered a patient with PBM and incomplete pancreatic divisum (PD). We herein discussed about the embryological etiology of pancreaticobiliary system predicted from PBM with incomplete PD. Case presentation A 67-year-old man was found to have a dilatation of the common bile duct (CBD) during a medical examination at 62 years of age. The dilatation of the CBD subsequently progressed, and he was admitted to our hospital for surgical treatment. Magnetic resonance cholangiopancreatography revealed a dilatation from the common hepatic duct to the middle bile duct with PBM. Endoscopic retrograde cholangiopancreatography from the papilla of Vater revealed the pancreatic main duct via the pancreatic branch duct, and PBM with dilatation of the CBD and incomplete PD were revealed. We performed an extrahepatic bile duct resection and hepaticojejunostomy because of high risk of malignant transformation. Taping and transection of the bile duct without dilatation on the pancreatic side were performed, and thereafter, two orifices of the common channel and ventral pancreatic duct were ligated. The level of amylase in the bile was 7217 IU/L, and a histological examination of the CBD showed an inflammatory change of CBD, not a malignant transformation. Conclusion It is somewhat easy to identify the pancreatobiliary anatomy when the cause of embryology of both PBM and PD is thought to be an abnormal embryology of the ventral pancreas.http://link.springer.com/article/10.1186/s12893-018-0385-4Pancreaticobiliary maljunctionIncomplete pancreatic divisumEmbryologyVentral pancreasEndoscopic retrograde cholangiopancreatography |
| spellingShingle | Yukihiro Sanada Yasunaru Sakuma Naohiro Sata Embryological etiology of pancreaticobiliary system predicted from pancreaticobiliary maljunction with incomplete pancreatic divisum: a case report BMC Surgery Pancreaticobiliary maljunction Incomplete pancreatic divisum Embryology Ventral pancreas Endoscopic retrograde cholangiopancreatography |
| title | Embryological etiology of pancreaticobiliary system predicted from pancreaticobiliary maljunction with incomplete pancreatic divisum: a case report |
| title_full | Embryological etiology of pancreaticobiliary system predicted from pancreaticobiliary maljunction with incomplete pancreatic divisum: a case report |
| title_fullStr | Embryological etiology of pancreaticobiliary system predicted from pancreaticobiliary maljunction with incomplete pancreatic divisum: a case report |
| title_full_unstemmed | Embryological etiology of pancreaticobiliary system predicted from pancreaticobiliary maljunction with incomplete pancreatic divisum: a case report |
| title_short | Embryological etiology of pancreaticobiliary system predicted from pancreaticobiliary maljunction with incomplete pancreatic divisum: a case report |
| title_sort | embryological etiology of pancreaticobiliary system predicted from pancreaticobiliary maljunction with incomplete pancreatic divisum a case report |
| topic | Pancreaticobiliary maljunction Incomplete pancreatic divisum Embryology Ventral pancreas Endoscopic retrograde cholangiopancreatography |
| url | http://link.springer.com/article/10.1186/s12893-018-0385-4 |
| work_keys_str_mv | AT yukihirosanada embryologicaletiologyofpancreaticobiliarysystempredictedfrompancreaticobiliarymaljunctionwithincompletepancreaticdivisumacasereport AT yasunarusakuma embryologicaletiologyofpancreaticobiliarysystempredictedfrompancreaticobiliarymaljunctionwithincompletepancreaticdivisumacasereport AT naohirosata embryologicaletiologyofpancreaticobiliarysystempredictedfrompancreaticobiliarymaljunctionwithincompletepancreaticdivisumacasereport |