Skip to main content
Log in

A case of pancreaticobiliary maljunction with a connecting duct without a long common channel

  • Case Report
  • Published:
Clinical Journal of Gastroenterology Aims and scope Submit manuscript


Pancreaticobiliary maljunction (PBM) is a congenital malformation in which the pancreatic and bile ducts join anatomically outside the duodenal wall, usually forming an abnormally long common channel. In PBM, since the long common channel defeats the effect of the sphincter of Oddi, pancreatobiliary reflux frequently occurs, resulting in high rates of biliary tract cancers. We present the case of a 68-year-old female with advanced gallbladder cancer concomitant with bile duct cancer associated with PBM without biliary dilatation that had an extremely rare configuration showing a connecting duct without a long common channel. Pancreatography in the selectively cannulated main pancreatic duct showed the terminal portion of the common bile duct via an abnormal connecting duct. Cholangiography in the selectively cannulated lower bile duct showed the main and accessory pancreatic ducts via the connecting duct. The bile amylase level was markedly elevated. This case of a rare configuration of PBM with a connecting duct without a long common channel is the first such reported case in the English literature.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others


  1. Kamisawa T, Ando H, Hamada Y, et al. Diagnostic criteria for pancreaticobiliary maljunction 2013. J Hepatobiliary Pancreat Sci. 2014;21:159–61.

    Article  PubMed  Google Scholar 

  2. Kamisawa T, Ando H, Suyama M, et al. Japanese clinical practice guidelines for pancreaticobiliary maljunction. J Gastroenterol. 2012;47:731–59.

    Article  PubMed  Google Scholar 

  3. Morine Y, Shiamda M, Takamatsu H, et al. Clinical features of pancreaticobiliary maljunction: update analysis of 2nd Japan-nationwide survey. J Hepatobiliary Pancreat Surg. 2013;20:472–80.

    Article  Google Scholar 

  4. Toki F, Tadokoro H, Yoshikawa T, et al. Pancreaticobiliary maljunction with uncommon complicated configuration. Tan to Sui. 1996;17:703–10 (in Japanese).

    Google Scholar 

  5. Nagakawa T, Ota T, Takeshita Y, et al. Clinical study on anomalous union of pancreatico-biliary duct system—with special reference to biliary diseases. I to Chou. 1985;20:361–8 (in Japanese with English abstract).

    Google Scholar 

  6. Oda I, Yamaguchi A, Sakoda K, et al. Two cases of the anomalous pancreato-biliary ductal system accompanied with cancer of biliary tract. Tando. 1987;1:454–61 (in Japanese with English abstract).

    Google Scholar 

  7. Kamisawa T, Egawa N, Nakajima H, et al. Origin of the long common channel based on pancreatographic findings in pancreaticobiliary maljunction. Dig Liver Dis. 2005;37:363–7.

    Article  CAS  PubMed  Google Scholar 

  8. Matsumoto Y, Fujii H, Itakura J, et al. Pancreaticobiliary maljunction: etiologic concepts based on radiologic aspects. Gastrointest Endosc. 2001;53:614–9.

    Article  CAS  PubMed  Google Scholar 

  9. Odgers PNB. Some observation on the development of the ventral pancreas in man. J Anat. 1930;65:1–7.

    CAS  PubMed  PubMed Central  Google Scholar 

  10. Oi I, Ohashi M. Embryological analysis of anomalous connection between the pancreatic and biliary ducts. Tan to Sui. 1982;3:463–76 (in Japanese).

    Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Terumi Kamisawa.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Human/animal Rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration.

Informed Consent

Informed consent was obtained from all patients for being included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kikuyama, M., Kamisawa, T., Kuruma, S. et al. A case of pancreaticobiliary maljunction with a connecting duct without a long common channel. Clin J Gastroenterol 10, 196–199 (2017).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: