{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T11:20:23Z","timestamp":1790680823670,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2013,6,20]],"date-time":"2013-06-20T00:00:00Z","timestamp":1371686400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2014,2]]},"abstract":"<jats:title>Abstract\u2003<\/jats:title><jats:p>Clinical practice guidelines on how to deal with pancreaticobiliary maljunction (<jats:styled-content style=\"fixed-case\">PBM<\/jats:styled-content>) were made in <jats:styled-content style=\"fixed-case\">J<\/jats:styled-content>apan in 2012, representing a world first. Using a narrow definition, congenital biliary dilatation involves only <jats:styled-content style=\"fixed-case\">T<\/jats:styled-content>odani type <jats:styled-content style=\"fixed-case\">I<\/jats:styled-content> (except type <jats:styled-content style=\"fixed-case\">I<\/jats:styled-content>b) and type <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>, both of which are accompanied by <jats:styled-content style=\"fixed-case\">PBM<\/jats:styled-content> in almost all cases. Prospective ultrasonographic study revealed that the maximum diameter of the common bile duct increased with age. Pathophysiological conditions due to pancreatobiliary reflux occur in patients with high confluence of the pancreaticobiliary ducts, a common channel \u22656\u2009mm long and occlusion of communication during contraction of the sphincter of <jats:styled-content style=\"fixed-case\">O<\/jats:styled-content>ddi. Since <jats:styled-content style=\"fixed-case\">PBM<\/jats:styled-content> can be diagnosed by magnetic resonance cholangiopancreatography, multi\u2010planar reconstruction multi\u2010detector row computed tomography and endoscopic ultrasonography, the current diagnostic criteria should be revised to take these diagnostic imaging modalities into consideration. According to a nationwide survey, biliary cancer occurred in 21.6% of adult patients with <jats:styled-content style=\"fixed-case\">PBM<\/jats:styled-content> with biliary dilatation and 42.2% of patients with <jats:styled-content style=\"fixed-case\">PBM<\/jats:styled-content> without biliary dilatation. In biliary cancer associated with <jats:styled-content style=\"fixed-case\">PBM<\/jats:styled-content> without biliary dilatation, 88.1% were gallbladder cancer. Treatment for <jats:styled-content style=\"fixed-case\">PBM<\/jats:styled-content> with biliary dilatation is prophylactic flow\u2010diversion surgery, but further investigations and surveillance studies are needed to clarify the appropriate surgical strategy for <jats:styled-content style=\"fixed-case\">PBM<\/jats:styled-content> without biliary dilatation.<\/jats:p>","DOI":"10.1002\/jhbp.8","type":"journal-article","created":{"date-parts":[[2013,6,20]],"date-time":"2013-06-20T10:28:56Z","timestamp":1371724136000},"page":"87-92","source":"Crossref","is-referenced-by-count":39,"title":["Recent advances and problems in the management of pancreaticobiliary maljunction: feedback from the guidelines committee"],"prefix":"10.1002","volume":"21","author":[{"given":"Terumi","family":"Kamisawa","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Tokyo Metropolitan Komagome Hospital  Tokyo 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