Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jul 8, 2015; 7(13): 1735-1741
Published online Jul 8, 2015. doi: 10.4254/wjh.v7.i13.1735
Pancreaticobiliary reflux as a high-risk factor for biliary malignancy: Clinical features and diagnostic advancements
Reiji Sugita
Reiji Sugita, Department of Radiology, Sendai City Medical Center, Sendai, Miyagi 983-8520, Japan
Author contributions: Sugita R solely contributed to this paper.
Conflict-of-interest statement: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Reiji Sugita, MD, Department of Radiology, Sendai City Medical Center, 5-22-1, Tsurugaya, Miyagino-ku, Sendai, Miyagi 983-8520, Japan. rsugita@openhp.or.jp
Telephone: +81-22-2521111 Fax: +81-22-2529431
Received: January 27, 2015
Peer-review started: January 28, 2015
First decision: March 6, 2015
Revised: March 18, 2015
Accepted: April 16, 2015
Article in press: April 20, 2015
Published online: July 8, 2015
Processing time: 164 Days and 4.9 Hours
Abstract

Pancreaticobiliary junction is composed of complex structure with which biliary duct and pancreatic duct assemble and go out into the ampulla of Vater during duodenum wall surrounding the sphincter of Oddi. Although the sphincter of Oddi functionally prevents the reflux of pancreatic juice, pancreaticobiliary reflux (PBR) occurs when function of the sphincter of Oddi halt. The anatomically abnormal junction is termed pancreaticobiliary maljunction (PBM) and is characterized by pancreatic and bile ducts joining outside of the duodenal wall. PBM is an important anatomical finding because many studies have revealed that biliary malignancies are related due to the carcinogenetic effect of the pancreatic back flow on the biliary mucosa. On the other hand, several studies have been published on the reflux of pancreatic juice into the bile duct without morphological PBM, and the correlation of such cases with biliary diseases, especially biliary malignancies, is drawing considerable attention. Although it has long been possible to diagnose PBM by various imaging modalities, PBR without PBM has remained difficult to assess. Therefore, the pathological features of PBR without PBM have not been yet fully elucidated. Lately, a new method of diagnosing PBR without PBM has appeared, and the features of PBR without PBM should soon be better understood.

Keywords: Pancreaticobiliary maljunction; Pancreas juice; Reflux; Flow; Magnetic resonance imaging

Core tip: Pancreaticobiliary reflux (PBR) is an important pathologic state that can cause biliary malignancy. PBR can occur regardless of whether the patient has pancreaticobiliary maljunction (PBM) or not. Although it has long been possible to diagnose PBM by various imaging modalities, PBR without PBM has remained difficult to assess. Therefore, the pathological features of PBR without PBM have not been yet fully elucidated. Lately, a new method of diagnosing PBR without PBM has appeared, and the features of PBR without PBM should soon be better understood.