Erschienen in:
01.11.2010 | Original article
Pancreatobiliary reflux and the length of a common channel
verfasst von:
Terumi Kamisawa, Masafumi Suyama, Naotaka Fujita, Hiroyuki Maguchi, Keiji Hanada, Seiyo Ikeda, Yoshinori Igarashi, Takao Itoi, Mitsuhiro Kida, Goro Honda, Jinkan Sai, Jun Horaguchi, Kuniyuki Takahashi, Takamitsu Sasaki, Kensuke Takuma, Fumihide Itokawa, Hisami Ando, Hiroo Takehara, The Committee of Diagnostic Criteria of The Japanese Study Group on Pancreaticobiliary Maljunction
Erschienen in:
Journal of Hepato-Biliary-Pancreatic Sciences
|
Ausgabe 6/2010
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Abstract
Background/purpose
Gallbladder cancer occurs frequently in patients with pancreaticobiliary maljunction due to pancreatobiliary reflux. Pancreatobiliary reflux is also detected in some patients with a relatively long common channel. This study aimed to clarify the correlation between pancreatobiliary reflux and the length of a common channel.
Methods
Two hundred and three patients, in whom both the length of a common channel and amylase level in the bile were measured, were enrolled from nine centers.
Results
Bile amylase level was correlated with the length of a common channel (P < 0.01). The minimum length of a common channel that could induce a markedly elevated amylase level in the bile (>1,000 mg/dl) was determined as 5 mm. We redefined high confluence of pancreatobiliary ducts (HCPBD) as cases with a common channel ≥5 mm, in which the communication between the pancreatic and bile ducts was occluded with the sphincter contraction. Gallbladder cancer was found in 20% of 56 redefined HCPBD patients. Bile amylase level >1,000 mg/dl and biliopancreatic reflux were detected in 79 and 95% of the patients, respectively.
Conclusions
Patients with a common channel ≥5 mm (redefined HCPBD) should be monitored for the development of gallbladder cancer, as they frequently showed significant pancreatobiliary reflux.