Huang Peng, Yang Hu, Kuang Houfang, Yang Jun, Duan Xufei, Bian Hongqiang, Wang Xin
Department of General Surgery, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430016, Hubei, China.
Dig Dis Sci. 2025 Apr 19. doi: 10.1007/s10620-025-09057-0.
Pancreaticobiliary maljunction is a congenital malformation in which the pancreatic and bile ducts join anatomically outside the duodenal wall, usually forming a markedly long common channel, which can cause reciprocal reflux between pancreatic juice and bile. Cholangiography, endoscopic ultrasonography, surgery, and autopsy can be used to diagnose pancreaticobiliary maljunction. Elevated amylase levels in bile and extrahepatic bile duct dilatation strongly suggest the existence of pancreaticobiliary maljunction. The regurgitation may lead to the development of various hepatobiliary and pancreatic disorders such as pancreatitis and biliary carcinoma. The pathogenesis of pancreaticobiliary maljunction is the result of a series of pathophysiological changes caused by reflux. Surgery is recommended for patients diagnosed with pancreaticobiliary maljunction irrespective of the presence or absence of symptoms because of its high biliary carcinogenicity, but the treatment strategy is quite different between adult patients with and without biliary dilatation.
胰胆管合流异常是一种先天性畸形，其中胰管和胆管在十二指肠壁外进行解剖学上的汇合，通常形成一条明显较长的共同通道，这可导致胰液和胆汁之间的相互反流。胆管造影、内镜超声检查、手术及尸检可用于诊断胰胆管合流异常。胆汁中淀粉酶水平升高及肝外胆管扩张强烈提示胰胆管合流异常的存在。反流可能导致各种肝胆和胰腺疾病的发生，如胰腺炎和胆管癌。胰胆管合流异常的发病机制是反流引起的一系列病理生理变化的结果。鉴于其较高的胆管致癌性，无论有无症状，建议对诊断为胰胆管合流异常的患者进行手术，但成年有胆管扩张和无胆管扩张患者的治疗策略有很大不同。
