[The common channel syndrome in adults]

Congenital abnormalities of the distal bile and pancreatic duct occur predominantly as a long common channel. A common channel of more than 15 mm is considered abnormal, since the length allows a reflux of pancreatic secretion into the bile duct and vice versa. The very rare occurrence of a long common channel syndrome in adults has been observed in two female patients (24 and 58 years old). Both presented cholangitis and/or pancreatitis. Diagnosis was established by ERCP. The definitive therapy in both cases was hepatico-jejunal anastomosis which improved symptoms in both patients. Endoscopic sphincterotomy is unsatisfactory since it does not cut the entire common channel. The rare etiology of a long common channel in patients with cholangitis and pancreatitis is safely verified by ERCP and safely cured by surgical intervention.