COMPUTATIONAL FLUID DYNAMICS IN PANCREATICOBILIARY JUNCTION

Abstract

Pancreaticobiliary maljunction without biliary dilation is associated with pancreaticobiliary reflux, a pathophysiologic factor underlying a wide range of diseases, including gallbladder cancer. This work used computational flow simulations to examine the mechanisms and relevant geometric features that influence pancreaticobiliary reflux and assess the impact of surgical interventions. The results suggest that the refilling phase is the primary mechanism driving pancreaticobiliary reflux. Moreover, the cystic duct diameter was the most critical factor determining the reflux dynamics. Furthermore, the configuration of the baffle system (the baffle height ratio and the number of baffles) affected the dynamics of pancreaticobiliary reflux. Also, the study underscores the potential therapeutic efficacy of cholecystectomy and endoscopic retrograde cholangiopancreatography in managing pancreaticobiliary reflux in cases of pancreaticobiliary maljunction without biliary dilatation. These interventions offer promising avenues for reducing reflux-related complications and mitigating the progression of associated diseases.