Prevalence of type III anomalous pancreaticobiliary junction in a tertiary care hospital of North India.

CONTEXT Anomalous junction of pancreaticobiliary ducts is a condition in which the pancreatic duct and the bile duct join outside the duodenal wall with a long common channel. The most accepted classification of various types of anomalous pancreaticobiliary junction is the new Komi classification. The majority of cases of type III anomalous pancreaticobiliary junction are reported from Japan and very seldom from outside Japan. This study evaluates the prevalence of type III anomalous pancreaticobiliary junction in the Indian population. OBJECTIVE To retrospectively evaluate the prevalence of type III anomalous pancreaticobiliary junction revealed by endoscopic retrograde cholangiopancreatography (ERCP) examinations carried out between 1985 and 2005. DESIGN ERCP records of 3,827 patients satisfying inclusion criteria between 1985 and 2005 were retrospectively analyzed. MAIN OUTCOME MEASURE Patients demonstrating anomalous pancreaticobiliary junction were identified and classified according to the new Komi classification. RESULTS A total of 101 patients had anomalous pancreaticobiliary junction (2.6% of all ERCP). Only 2 patients (2.0% of all anomalous pancreaticobiliary junction cases and 0.05% of all ERCP examinations) had type III anomalous pancreaticobiliary junction. Both cases were associated with choledochal cysts and chronic pancreatitis. CONCLUSION Type III anomalous pancreaticobiliary junction is a rare occurrence in Indian patients as compared to Japanese patients in whom the majority of cases are reported. This demographic variation is still unexplained.