Erschienen in:
01.05.2014 | Original Article—Liver, Pancreas, and Biliary Tract
Pancreatobiliary reflux in individuals with a normal pancreaticobiliary junction: a prospective multicenter study
verfasst von:
Jun Horaguchi, Naotaka Fujita, Terumi Kamisawa, Goro Honda, Kazuo Chijiiwa, Hiroyuki Maguchi, Masao Tanaka, Mitsuo Shimada, Yoshinori Igarashi, Kazuo Inui, Keiji Hanada, Takao Itoi, Yoshinori Hamada, Tsugumichi Koshinaga, Hideki Fujii, Naoto Urushihara, Hisami Ando, The committee of Diagnostic Criteria of The Japanese Study Group on Pancreaticobiliary Maljunction
Erschienen in:
Journal of Gastroenterology
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Ausgabe 5/2014
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Abstract
Background
Pancreatobiliary reflux (PBR) can occur in individuals without pancreaticobiliary maljunction. The aim of this study was to elucidate the incidence of PBR in individuals with a normal pancreaticobiliary junction and its impact on the biliary tree.
Methods
Data were prospectively collected from 15 centers on 420 patients with a morphologically normal pancreaticobiliary junction who had undergone bile sampling and measurement of the biliary amylase level. We investigated the incidence and predictive factors for high biliary amylase levels (HBAL), as well as the relationship of HBAL with biliary malignancy.
Results
Twenty-three patients (5.5 %) showed HBAL (≥10,000 IU/L). Univariate analysis showed that risk factors for the elevation of biliary amylase levels were the existence of a relatively long common channel (≥5 mm), acute pancreatitis, and papillitis. Multivariate analysis revealed that only the existence of a relatively long common channel was a significant factor for PBR. Biliary amylase levels in patients with a relatively long common channel were significantly higher than in patients without a long common channel (12,333 vs. 2,070 IU/L, P = 0.001). The incidence of HBAL (P < 0.001), as well as the overall biliary amylase levels (P = 0.007) were significantly higher in patients with gallbladder cancer than in those without gallbladder cancer.
Conclusions
The PBR was frequently observed in individuals with a relatively long common channel. Patients showing HBAL with normal pancreaticobiliary junction are at high risk for gallbladder cancer.