Abstract
AIM: To demonstrate the imaging findings of biliopancreatic and pancreatico-biliary reflux in patients with anomalous union of the pancreatico-biliary duct (AUPBD) on gadoxetic acid-enhanced functional magnetic resonance cholangiography (fMRC). METHODS: This study included six consecutive patients (two men and four women; mean age 47.5 years) with AUPBD. All subjects underwent endoscopic retrograde cholangiopancreatography (ERCP); one subject also underwent bile sampling of the common bile duct (CBD) to measure the amylase level because his gadoxetic acid-enhanced fMRC images showed evidence of pancreatico- biliary reflux of pancreatic secretions. Of the five patients with choledochal cysts, four underwent pylorus-preserving pancreaticoduodenectomy. RESULTS: The five cases of choledochal cysts were classified as Todani classification. In three of the six patients with AUPBD, injected contrast media reached the distal CBD and pancreatic duct on delay images, suggesting biliopancreatic reflux. In two of these six patients, a band-like filling defect was noted in the CBD on pre-fatty meal images, which decreased in size on delayed post-fatty meal images, suggesting pancreatico- biliary reflux of pancreatic secretions, and the bile sampled from the CBD in one patient had an amylase level of 113 000 IU/L. In one of the six patients with AUPBD, contrast media did not reach the distal CBD due to multiple CBD stones. CONCLUSION: Gadoxetic acid-enhanced fMRC successfully demonstrated biliopancreatic reflux of bile and pancreatico- biliary reflux of pancreatic secretions in patients with AUPBD with and without choledochal cysts.
| Original language | English |
|---|---|
| Pages (from-to) | 952-959 |
| Number of pages | 8 |
| Journal | World Journal of Gastroenterology |
| Volume | 18 |
| Issue number | 9 |
| DOIs | |
| Publication status | Published - 2012 Mar 7 |
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Keywords
- Bile reflux
- Choledochal cyst
- Encoscopic retrograde cholangio-pancreatography
- Gadolinium-ethoxybenzyl- diethylenetriamine penta-acetic acid
- Magnetic resonance imaging
ASJC Scopus subject areas
- Gastroenterology
Cite this
Biliary reflux detection in anomalous union of the pancreatico-biliary duct patients. / Yeom, Suk Keu; Lee, Seung Hwa; Cha, Sang Hoon; Chung, Hwan Hoon; Je, Bo-Kyung; Kim, Baek Hyun; Hyun, Jong Jin.
In: World Journal of Gastroenterology, Vol. 18, No. 9, 07.03.2012, p. 952-959.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Biliary reflux detection in anomalous union of the pancreatico-biliary duct patients
AU - Yeom, Suk Keu
AU - Lee, Seung Hwa
AU - Cha, Sang Hoon
AU - Chung, Hwan Hoon
AU - Je, Bo-Kyung
AU - Kim, Baek Hyun
AU - Hyun, Jong Jin
PY - 2012/3/7
Y1 - 2012/3/7
N2 - AIM: To demonstrate the imaging findings of biliopancreatic and pancreatico-biliary reflux in patients with anomalous union of the pancreatico-biliary duct (AUPBD) on gadoxetic acid-enhanced functional magnetic resonance cholangiography (fMRC). METHODS: This study included six consecutive patients (two men and four women; mean age 47.5 years) with AUPBD. All subjects underwent endoscopic retrograde cholangiopancreatography (ERCP); one subject also underwent bile sampling of the common bile duct (CBD) to measure the amylase level because his gadoxetic acid-enhanced fMRC images showed evidence of pancreatico- biliary reflux of pancreatic secretions. Of the five patients with choledochal cysts, four underwent pylorus-preserving pancreaticoduodenectomy. RESULTS: The five cases of choledochal cysts were classified as Todani classification. In three of the six patients with AUPBD, injected contrast media reached the distal CBD and pancreatic duct on delay images, suggesting biliopancreatic reflux. In two of these six patients, a band-like filling defect was noted in the CBD on pre-fatty meal images, which decreased in size on delayed post-fatty meal images, suggesting pancreatico- biliary reflux of pancreatic secretions, and the bile sampled from the CBD in one patient had an amylase level of 113 000 IU/L. In one of the six patients with AUPBD, contrast media did not reach the distal CBD due to multiple CBD stones. CONCLUSION: Gadoxetic acid-enhanced fMRC successfully demonstrated biliopancreatic reflux of bile and pancreatico- biliary reflux of pancreatic secretions in patients with AUPBD with and without choledochal cysts.
AB - AIM: To demonstrate the imaging findings of biliopancreatic and pancreatico-biliary reflux in patients with anomalous union of the pancreatico-biliary duct (AUPBD) on gadoxetic acid-enhanced functional magnetic resonance cholangiography (fMRC). METHODS: This study included six consecutive patients (two men and four women; mean age 47.5 years) with AUPBD. All subjects underwent endoscopic retrograde cholangiopancreatography (ERCP); one subject also underwent bile sampling of the common bile duct (CBD) to measure the amylase level because his gadoxetic acid-enhanced fMRC images showed evidence of pancreatico- biliary reflux of pancreatic secretions. Of the five patients with choledochal cysts, four underwent pylorus-preserving pancreaticoduodenectomy. RESULTS: The five cases of choledochal cysts were classified as Todani classification. In three of the six patients with AUPBD, injected contrast media reached the distal CBD and pancreatic duct on delay images, suggesting biliopancreatic reflux. In two of these six patients, a band-like filling defect was noted in the CBD on pre-fatty meal images, which decreased in size on delayed post-fatty meal images, suggesting pancreatico- biliary reflux of pancreatic secretions, and the bile sampled from the CBD in one patient had an amylase level of 113 000 IU/L. In one of the six patients with AUPBD, contrast media did not reach the distal CBD due to multiple CBD stones. CONCLUSION: Gadoxetic acid-enhanced fMRC successfully demonstrated biliopancreatic reflux of bile and pancreatico- biliary reflux of pancreatic secretions in patients with AUPBD with and without choledochal cysts.
KW - Bile reflux
KW - Choledochal cyst
KW - Encoscopic retrograde cholangio-pancreatography
KW - Gadolinium-ethoxybenzyl- diethylenetriamine penta-acetic acid
KW - Magnetic resonance imaging
UR - http://www.scopus.com/inward/record.url?scp=84863266732&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84863266732&partnerID=8YFLogxK
U2 - 10.3748/wjg.v18.i9.952
DO - 10.3748/wjg.v18.i9.952
M3 - Article
VL - 18
SP - 952
EP - 959
JO - World Journal of Gastroenterology
JF - World Journal of Gastroenterology
SN - 1007-9327
IS - 9
ER -