Classification of pancreaticobiliary maljunction and clinical features in children.

Abstract

BACKGROUND:

In 2015, the Committee on Diagnostic Criteria of the Japanese Study Group on Pancreaticobiliary Maljunction (PBM) proposed a classification of PBM into four types: (A) stenotic type, (B) non-stenotic type, (C) dilated channel type, and (D) complex type. To validate this classification and clarify the clinical features of the four types of PBM, a retrospective multicenter study was conducted.

METHODS:

The study group of 317 children with PBM was divided into the four types of PBM. Clinical features, preoperative complications, operations, and postoperative pancreatic complications were evaluated.

RESULTS:

All patients underwent excision of the extrahepatic bile duct. In type A, the age was younger and there was a higher incidence of cystic dilatation. Non-dilatation of the common bile duct was frequently seen in type B. Abdominal pain with hyperamylasemia was frequently seen in types B and C. In particular, the incidence of protein plugs and biliary perforation was high in type C (56.1% and 14.3%, respectively). The overall incidence of acute pancreatitis was 7.3%. Pancreatitis after excisional surgery was rare in the children in this study. Two patients with type D (0.6%) developed chronic pancreatitis postoperatively.

CONCLUSIONS:

This proposed classification is simple and correlates well with clinical features.

• Authors: Naoto Urushihara, Yoshinori Hamada, Terumi Kamisawa, Hideki Fujii, Tsugumichi Koshinaga, Yoshiki Morotomi, Takeshi Saito, Takao Itoi, Kenitiro Kaneko, Hiroaki Fukuzawa, Hisami Ando
• Journal: Journal of hepato-biliary-pancreatic sciences (J Hepatobiliary Pancreat Sci) Vol. 24 Issue 8 Pg. 449-455 (Aug 2017) ISSN: 1868-6982 [Electronic] Japan
• PMID: 28639336 (Publication Type: Comparative Study, Journal Article)
• Copyright: © 2017 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

Topics

• Adolescent
• Biliary Tract (abnormalities)
• Biliary Tract Diseases (classification, mortality, surgery)
• Child
• Child, Preschool
• Cholangiopancreatography, Endoscopic Retrograde (methods)
• Cohort Studies
• Digestive System Abnormalities (diagnosis, epidemiology, surgery)
• Female
• Humans
• Incidence
• Japan (epidemiology)
• Male
• Pancreatic Diseases (classification, mortality, surgery)
• Pancreatic Ducts (abnormalities, surgery)
• Prognosis
• Retrospective Studies
• Risk Assessment
• Statistics, Nonparametric
• Survival Rate
• Tomography, X-Ray Computed (methods)