Clinical significance of anomalous pancreaticobiliary union

Anomalous pancreaticobiliary union was found in nine cases among 300 consecutive adult patients examined by endoscopic retrograde cholangiopancreatography. Three had congenital choledochal cysts: one had a cyst of the choledochus associated with a cyst of the intrahepatic bile duct, another had a fusiform dilation of the choledochus, and the third had a choledochal diverticulum. Five of the nine patients had biliary malignancies (55.6%): four carcinomas of the gallbladder and one carcinoma of the choledochus. On the other hand, 18 of 291 patients without anomalous pancreaticobiliary union had biliary malignancies (6.2%): four carcinomas of the gallbladder and 14 carcinomas of the choledochus. When anomalous pancreaticobiliary union is detected, biliary malignancy, especially carcinoma of the gallbladder, should be considered as a possible complication.