Objective To investigate the relationship between anomalous pancreaticobiliary junction(APBJ) without congenital choledochal cyst (CCC) and onset of acute pancreatitis. Methods Between Jan. 1995 and Jan. 2004, 72 cases of APBJ without CCC were identified by ERCP, MRCP, and intraoperative cholangiography(IOC).Relationship between acute pancreatitis and APBJ was analysed retrospectively. Result The overall incidence of APBJ in this series was 2.7%. Pancreaticobiliary junction anomaly was further substratified into as P-C type(the pancreatic duct joining the common bile duct)in 43 cases, and C-P type (the common bile duct joining the pancreatic duct)in 29 cases. The incidence of acute pancreatitis was 35% and that of gallbladder stone was 74%. Conclusion The incidence of acute pancreatitis in APBJ without CCC is high. In case of relapsing acute pancreatitis without known cause, APBJ should be suspected. Prophylactic cholecystectomy is effective to prevent acute pancreatitis.

ObjectiveTo evaluate intraoperative cholangiograhy during cholecystectomy for patients with preoperative benign gallbladder disease. Methods Unexpected biliary disease and anomaly found by intraoperative cholangiography in 904 cases of preoperatively diagnosed simple gallbladder stone and polypoid lesions were analyzed. Results Choledocholithiasis was found in 79 cases, anomalous pancreaticobiliary junction (APBJ)in 21, gallbladder cystic duct variations in 28, right accessory hepatic duct in 4 . Conclusions Intraoperative cholangiograhy during the process of simple cholecystectomy helps to discover preoperatively mis-diagnosed choledocholithiasis, hence to avoid secondary exploration of common bile duct which is otherwise inevitable, it may also demonstrate the anomalous pancreaticobiliary junction and bile ductal anatomic variations.