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Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
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Classification of pancreaticobiliary maljunction and clinical features in children

Naoto Urushihara1,2, Yoshinori Hamada1,3, Terumi Kamisawa1,4

  • 1The Committee on Diagnostic Criteria of the Japanese Study Group on Pancreaticobiliary Maljunction, The Com, The Com.

Journal of Hepato-Biliary-Pancreatic Sciences
|June 23, 2017
PubMed

Insights

The 2015 classification of Pancreaticobiliary Maljunction (PBM) into four types is validated by this study. The classification effectively correlates with distinct clinical features in children with PBM.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Diagnostic Criteria

Background:

  • The Japanese Study Group on Pancreaticobiliary Maljunction (PBM) proposed a four-type classification in 2015.
  • This classification includes stenotic, non-stenotic, dilated channel, and complex types of PBM.
  • A multicenter study was conducted to validate this classification and elucidate clinical features.

Purpose of the Study:

  • To validate the proposed four-type classification of Pancreaticobiliary Maljunction (PBM).
  • To clarify the clinical features associated with each of the four PBM types in pediatric patients.

Main Methods:

  • A retrospective multicenter study involving 317 children diagnosed with PBM.
  • Patients were categorized into the four proposed PBM types.
  • Evaluation of clinical features, preoperative complications, surgical procedures, and postoperative pancreatic complications.

Main Results:

  • Type A PBM was associated with younger age and higher incidence of cystic dilatation.
  • Type B PBM frequently showed non-dilatation of the common bile duct.
  • Types B and C exhibited high incidences of abdominal pain with hyperamylasemia; Type C had significant rates of protein plugs and biliary perforation.
  • Overall acute pancreatitis incidence was 7.3%, with rare postoperative pancreatitis. Two Type D patients developed chronic pancreatitis.

Conclusions:

  • The proposed classification system for Pancreaticobiliary Maljunction (PBM) is simple.
  • This classification demonstrates a strong correlation with the clinical features observed in pediatric patients.
Abstract

Keywords:
Choledochal cystClassificationCongenital biliary dilatationPancreaticobiliary maljunctionPancreatitis

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