Pancreaticobiliary

Pancreaticobiliary refers to the anatomical and physiological relationship between the pancreas and the biliary system, including the liver, gallbladder, bile ducts, and the pancreatic ducts. The exocrine pancreas produces digestive enzymes that reach the duodenum via the main pancreatic duct, while the biliary system transports bile produced by the liver and stored in the gallbladder, delivered to the duodenum through the common bile duct and the hepatopancreatic ampulla (ampulla of Vater).

Normally, the pancreatic duct and the common bile duct join at the hepatopancreatic ampulla and drain into the second portion of the duodenum, controlled by the sphincter of Oddi. This integration allows synchronized release of pancreatic enzymes and bile during digestion.

Developmentally, the pancreatic and biliary ducts form and fuse during embryogenesis. An abnormal junction of these ducts outside the duodenal wall is called pancreaticobiliary maljunction, which can permit reflux between systems and has been linked with various biliary diseases and, in some cases, increased cancer risk.

Common clinical considerations involve pancreatitis, biliary colic or cholelithiasis, cholangitis, and biliary obstruction. Evaluation often employs imaging modalities such as ultrasound, magnetic resonance cholangiopancreatography (MRCP), and endoscopic retrograde cholangiopancreatography (ERCP).

Management is disease-specific and may range from observation and medical therapy to endoscopic or surgical interventions to restore drainage and prevent complications. The pancreaticobiliary system is essential for digestion and for maintaining the flow of digestive secretions between the liver, gallbladder, and pancreas.