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Gallbladder carcinoma associated with pancreatobiliary reflux
Jin Kan Sai1, Masafumi Suyama, Yoshihiro Kubokawa
1Department of Gastroenterology, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan. jinkans@med.juntendo.ac.jp
World Journal of Gastroenterology
|October 31, 2006
Summary
Patients with pancreaticobiliary maljunction and high biliary amylase levels may have gallbladder cancer. Ultrasonography and bile sampling can help detect these conditions in patients with and without pancreaticobiliary maljunction.
Area of Science:
- Gastroenterology
- Hepatobiliary Surgery
- Diagnostic Imaging
Background:
- Pancreaticobiliary maljunction (PBM) is a congenital anomaly.
- Elevated biliary amylase levels can indicate pancreatobiliary reflux.
- Gallbladder wall thickening on ultrasound may suggest PBM.
Purpose of the Study:
- To identify patients with and without PBM exhibiting pancreatobiliary reflux with extremely high biliary amylase levels.
- To investigate the association between high biliary amylase and gallbladder carcinoma in PBM patients.
Main Methods:
- Prospective study of 96 patients with suspected PBM on ultrasonography.
- Endoscopic retrograde cholangiopancreatography (ERCP) with common bile duct bile sampling.
- Clinicopathological examination of patients with extremely high biliary amylase (>10000 IU/L) undergoing cholecystectomy.
Main Results:
- 17 patients had extremely high biliary amylase levels (>10000 IU/L).
- 11 of these patients had PBM, and 6 did not.
- Gallbladder carcinoma occurred in 45.5% of PBM patients and 50% of non-PBM patients with high amylase.
Conclusions:
- Extremely high biliary amylase levels indicate pancreatobiliary reflux and are associated with gallbladder carcinoma in patients with and without PBM.
- Ultrasonography and bile sampling are valuable tools for detecting these conditions.
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