Anomalous pancreaticobiliary duct junction presenting as benign biliary stricture

Anomalous pancreaticobiliary duct junction occurs when the pancreatic and bile ducts unite outside the duodenal wall, typically forming a notably long common channel. This condition leads to the regurgitation of bile and pancreatic secretions between the pancreaticobiliary and biliopancreatic tracts. Clinical presentations can vary, ranging from abdominal pain and pancreatitis to malignancy. Prompt diagnosis and management are crucial to prevent further complications.This study focuses on two female patients who presented with abdominal pain, jaundice, and fever. Owing to the presence of two papillae in communication with one another, as observed in both imaging and endoscopic retrograde cholangiopancreatography (ERCP), along with common bile duct dilatation, both patients were diagnosed with type III-C3 pancreaticobiliary maljunction. The first patient was managed with ERCP, followed by hepaticojejunostomy; however, the second patient declined any intervention and received conservative management.