A Case of Anomalous Arrangement of Pancreaticobiliary Ductal System Treated with Cholecystectomy and Endoscopic Sphincteropapillotomy

Yoshiharu Sakai, Kazuo Ida, Kazuaki Nishimura, Yuzo Yamamoto, Hitoshige Lin, Syouji Hisano

Gastrointestinal Disease Center, Kyoto Katsura Hospital

A 68-year-old woman underwent cholecystectomy for gallstone. An anomalous arrangement of the pancreaticobiliary ductal system was suspected postoperatively from T-tube cholangiography, and was confirmed by endoscopic retrograde cholangiopancreatography. The length of the common duct was approximately 15 mm. The common bile duct was not dilated but had two small diverticula. The amylase level in bile was measured before and after eating. The level rose remarkably after eating, indicating reflux of the pancreatic juice into the bile duct. Endoscopic sphincteropapillotomy (EST) was performed. The amylase level then remained in the normal range even after eating. It is suggested that EST could be one of the therapeutic modalities for anomalous arrangement of the pancreaticobiliary ductal system.

Key words
anomalous arrangement of panereaticobiliary ductal system, endoscopic sphincteropapillotomy

Reprint requests
Yoshiharu Sakai Gastrointestinal Disease Center, Kyoto Katsura Hospital
17 Yamadahirao-cho, Nishikyo-ku, Kyoto 615 JAPAN

Accepted
February 9, 1994

To read the PDF file you will need Abobe Reader installed on your computer.