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Pancreatobiliary reflux and the length of a common channel
Author(s) -
Kamisawa Terumi,
Suyama Masafumi,
Fujita Naotaka,
Maguchi Hiroyuki,
Hanada Keiji,
Ikeda Seiyo,
Igarashi Yoshinori,
Itoi Takao,
Kida Mitsuhiro,
Honda Goro,
Sai Jinkan,
Horaguchi Jun,
Takahashi Kuniyuki,
Sasaki Takamitsu,
Takuma Kensuke,
Itokawa Fumihide,
Ando Hisami,
Takehara Hiroo
Publication year - 2010
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1007/s00534-010-0282-4
Subject(s) - reflux , medicine , gastroenterology , gallbladder , bile reflux , common bile duct , amylase , sphincter , gallbladder cancer , radiology , biology , disease , biochemistry , enzyme
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.