CLINICAL ABNORMALITIES IN ADULTS WITH PANCREATICOBILIARY MALJUNCTION WITH AND WITHOUT BILE-DUCT DILATATION

OBJECTIVE: To study clinical diseases associated with pancreaticobilia ry maljunction with or without bile-duct dilatation. DESIGN: A retrosp ective study over 16 years. SETTING: A single university surgical serv ice in Japan. PATIENTS: Thirty-three patients with pancreaticobiliary maljunction. MAIN OUTCOME MEASURES: Gallstones and cancer in patients with and without bile-duct dilatation. RESULTS: Twenty-five patients h ad dilatation of the bile duct, 8 did not. Seven (28%) of the 25 patie nts with bile-duct dilatation had gallstones compared with 1 (12%) of the 8 patients with no dilatation. Seven (88%) of the 8 patients with no dilatation had carcinoma (all of the gallbladder), but only 3 (12%) of the 25 patients with bile-duct dilatation had carcinoma (1 of the gallbladder, 2 of the bile duct). CONCLUSION: Prophylactic cholecystec tomy is recommended for patients with pancreaticobiliary maljunction a nd no dilatation of the bile duct because of the high incidence of gal lbladder cancer.