Biliary Findings and the Neoplastic Potential of Branch Duct Intraductal Papillary Mucinous Neoplasm  James L. Buxbaum, MD  Clinical Gastroenterology and Hepatology  Volume 11, Issue 5, Pages 555-557 (May 2013) DOI: 10.1016/j.cgh.2013.01.031 Copyright © 2013 AGA Institute Terms and Conditions

Figure 1 Bidirectional reflux and abnormalities of the bile duct, gallbladder, and pancreas. Reflux of pancreatic juice into the bile duct may result in choledochal cyst (A). In those with a normal bile duct, pancreaticobiliary reflux is associated with gallbladder carcinoma (B). Matsuzaki et al propose that reflux of bile into the pancreatic duct may promote BD-IPMN (C). Bidirectional reflux occurs in those with PBM caused by an abnormal insertion of the bile into the pancreatic duct (i) or long common channel (ii). However, it can also occur in those with a normal pancreaticobiliary junction (iii). Clinical Gastroenterology and Hepatology 2013 11, 555-557DOI: (10.1016/j.cgh.2013.01.031) Copyright © 2013 AGA Institute Terms and Conditions