Pancreaticobiliary ductal union in cholangiocarcinoma

Entry points of the pancreatic and bile ducts into the duodenum were adequately visualized on endoscopic retrograde cholangiopancreatography in 23 confirmed patients with cholangiocarcinoma. The group comprised 19 men and four women, and age ranged from 25 to 70 years. In 21 patients (91.3%) a common channel was present, whereas in 2 patients the pancreatic and bile ducts opened separately into the duodenum. The mean length +/- SD of the common channel in patients of cholangiocarcinoma was 6.43 +/- 5.23 mm, which was comparable to the length of the common channel in 25 normal subjects (mean +/- SD, 5.30 +/- 3.81 mm). The common channel was less than 8 mm long in 19 patients. An anomalous pancreato-biliary duct was present in two patients, and in one of these patients cholangiocarcinoma developed in an already existing choledochal cyst. A long common channel is an infrequent finding in cholangiocarcinoma, and pancreato-biliary reflux appears to be an insignificant factor in the cause of this disease.