Double-Duct Sign in the Clinical Context

作者：Sinha Rohit^*; Gardner Terri; Padala Krishnaveni; Greenaway John Richard; Joy Diamond

来源：Pancreas, 2015, 44(6): 967-970.

DOI：10.1097/MPA.0000000000000372

• common bile duct and pancreatic duct dilatation
• double-duct sign
• jaundice
• MRCP
• CT - computed tomography
• ERCP - endoscopic retrograde cholangiopancreatogram
• EUS - endoscopic ultrasound
• MRCP - magnetic resonance cholangiopancreatogram
• PD - pancreatic duct

Objectives Double-duct sign (combined dilatation of the common bile duct and pancreatic duct) is an infrequently encountered finding in cross-sectional radiological imaging of the pancreatobiliary system. This sign is commonly deemed to signify on ominous pathology and suggests the presence of pancreatic or biliary malignancy.
Methods We aim to correlate double-duct sign discovered on magnetic resonance cholangiopancreatogram (MRCP) in the clinical context. We retrospectively analyzed MRCP database over a period of 4 years, January 2010 to December 2013. Follow-up information was available for a median of 27 months (range, 12-42 months)
Results The commonest cause of double-duct sign was choledocholithiasis followed closely by pancreatobiliary malignancy. Patients with jaundice in the context of double-duct sign had a higher incidence of malignancy (48%). None of the anicteric patients were found to have malignancy (P = 0.002).
Conclusions In patients with MRCP evidence of double-duct sign, the absence of jaundice makes a malignant etiology unlikely. Conversely, in jaundiced patients, a malignant cause is much more likely. Figures from larger series are needed to support this conclusion.

• 出版日期2015-8