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World J Gastroenterol. Oct 28, 2006; 12(40): 6527-6530
Published online Oct 28, 2006. doi: 10.3748/wjg.v12.i40.6527
Gallbladder carcinoma associated with pancreatobiliary reflux
Jin Kan Sai, Masafumi Suyama, Yoshihiro Kubokawa, Bunsei Nobukawa
Jin Kan Sai, Masafumi Suyama, Yoshihiro Kubokawa, Department of Gastroenterology, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
Bunsei Nobukawa, Department of Pathology, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
Correspondence to: Jin Kan Sai, MD, Department of Gastroenterology, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan. jinkans@med.juntendo.ac.jp
Telephone: +81-3-58021061 Fax: +81-3-56845960
Received: July 6, 2006
Revised: July 12, 2006
Accepted: July 30, 2006
Published online: October 28, 2006
Abstract

AIM: To detect the patients with and without pan-creaticobiliary maljunction who had pancreatobiliary reflux with extremely high biliary amylase levels.

METHODS: Ninety-six patients, who had diffuse thickness (> 3 mm) of the gallbladder wall and were suspected of having a pancreaticobiliary maljunction on ultrasonography, were prospectively subjected to endoscopic retrograde cholangiopancreatography, and bile in the common bile duct was sampled. Among them, patients, who had extremely high biliary amylase levels (>10 000 IU/L), underwent cholecystectomy, and the clinicopathological findings of those patients with and without pancreaticobiliary maljunction were examined.

RESULTS: Seventeen patients had biliary amylase levels in the common bile duct above 10 000 IU/L, including 11 with pancreaticobiliary maljunction and 6 without pancreaticobiliary maljunction. The occurrence of gallbladder carcinoma was 45.5% (5/11) in patients with pancreaticobiliary maljunction, and 50% (3/6) in those without pancreaticobiliary maljunction.

CONCLUSION: Pancreatobiliary reflux with extremely high biliary amylase levels and associated gallbladder carcinoma could be identified in patients with and without pancreaticobiliary maljunction, and those patients might be detected by ultrasonography and bile sampling.

Keywords: Amylase; Bile; Gallbladder carcinoma; Pancreatobiliary reflux; Pancreaticobiliary maljunction; Diagnosis