Objective   To study the pathogenesis of recurrent pancreatitis (RP) and its surgical procedure.     Methods    Diagnosis of abnormal pancreaticobiliary junction was established in 46 patients with RP by magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP) before operation

measurement of bile amylase level and biliary tract pressure during operation

and choledochoscopy

respectively

for bile duct transection to thoroughly  eliminate the reflux to biliary tract.     Results    A more than 1.0 cm long common channel was found in 13 out of the 46 patients. The level of bile amylase was two-fold higher than that of serum amylase. The mean biliary tract pressure was higher before operation than after operation. The symptoms of the patients were completely relieved after operation. No abdominal pain occurred in 24 patients during the 52-month follow- up.    Conclusion   Bile reflux to pancreatic duct due to abnormal pancreaticobiliary junction is the major cause of RP

which can be diagnosed based on its clinical symptoms such as choledochectasia

common channel length

bile amylase level

dilated common bile duct

and choledochojejunostomy findings. Combined common bile duct transection is an effective procedure for RP.