Clinico-radiological attributes of abnormal pancreaticobiliary junction

IF 2.2 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Abdominal Radiology Pub Date : 2025-04-03 DOI:10.1007/s00261-025-04917-9

Shravya Bhargavi Dontheneni, Aasritha Kotha, Tharani Putta, Shashank Chapala, Suvarna Naidu Nagipagu

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引用次数: 0

Abstract

Aims

To evaluate the prevalence of abnormal pancreaticobiliary junction (APBJ) on Magnetic Resonance Cholangio-Pancreatography (MRCP) in patients with and without choledochal cyst (CDC), and study their clinico-radiological profile.

Methods

We have retrospectively screened all MRCP studies (n = 13,482) done in our Radiology department over 18 months and documented the presence and type of APBJ (any length of extra-duodenal common channel) and CDC, other co-existing pancreaticobiliary abnormalities including complications.

Results

Prevalence of APBJ was 0.5% (n = 67) with 77% of them showing CDC (52/67) while only 0.85% of patients without APBJ have CDC (p value < 0.0001). The most common type of CDC associated with APBJ was Todani Type I (86%) followed by type IV (14%). 31% of CDC patients had APBJ (52 out of 165) while the majority of patients with CDC (69%) did not have APBJ. Between the CDC (n = 52) and non-CDC (n = 15) subgroups of APBJ, there was statistically significant difference in the age (25 vs. 40 years, p value 0.003), gender, length of common channel (14.4 ± 6 mm vs. 10.6 ± 5 mm, p value 0.03), JSPBM type of APBJ and the risk of biliary malignancy (1.9% vs. 26.7%, p value 0.008, Odds ratio 13.8). Although idiopathic pancreatitis was also more common in the non-CDC subgroup, this difference was not statistically significant. There was no statistical correlation between the length of common channel and occurrence of CDC, biliary calculi, malignancy or pancreatitis.

Conclusion

Any length of common pancreaticobiliary channel outside the duodenal wall must be considered as APBJ; there is no correlation between the actual length of common channel and occurrence of its complications. The often overlooked and underdiagnosed subgroup of APBJ without biliary dilatation are 13.8 times more likely to develop biliary malignancy than the CDC group. We therefore suggest a necessary shift in surveillance strategies and advocate for routine screening of patients with APBJ for any biliary malignancy, even in the absence of CDC, and perhaps subject them to prophylactic cholecystectomy.

Graphical Abstract

查看原文本刊更多论文

胰胆交界处异常的临床影像学特征。

目的：评价有无胆总管囊肿（CDC）患者的磁共振胆道胰腺造影（MRCP）显示的胰胆交界处异常（APBJ）的发生率，并研究其临床影像学特征。方法：我们回顾性筛选了18个月来在放射科进行的所有MRCP研究（n = 13,482），记录了APBJ（任何长度的十二指肠外共通道）和CDC的存在和类型，其他共存的胰胆管异常包括并发症。结果：APBJ的患病率为0.5% (n = 67)，其中有CDC的占77%(52/67)，而无APBJ的患者中有CDC的仅占0.85% （p值）。结论：十二指肠壁外任何长度的胰胆共道均应考虑为APBJ；共通道的实际长度与其并发症的发生无相关性。无胆道扩张的APBJ常被忽视和诊断不足的亚组发生胆道恶性肿瘤的可能性是CDC组的13.8倍。因此，我们建议对监测策略进行必要的转变，并提倡对APBJ患者进行常规筛查，以发现任何胆道恶性肿瘤，即使在没有CDC的情况下，也可能对他们进行预防性胆囊切除术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Abdominal Radiology Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

5.20

自引率

8.30%

发文量

334

期刊介绍： Abdominal Radiology seeks to meet the professional needs of the abdominal radiologist by publishing clinically pertinent original, review and practice related articles on the gastrointestinal and genitourinary tracts and abdominal interventional and radiologic procedures. Case reports are generally not accepted unless they are the first report of a new disease or condition, or part of a special solicited section. Reasons to Publish Your Article in Abdominal Radiology: · Official journal of the Society of Abdominal Radiology (SAR) · Published in Cooperation with: European Society of Gastrointestinal and Abdominal Radiology (ESGAR) European Society of Urogenital Radiology (ESUR) Asian Society of Abdominal Radiology (ASAR) · Efficient handling and Expeditious review · Author feedback is provided in a mentoring style · Global readership · Readers can earn CME credits