Gallbladder cancer with a low junction of the cystic duct or an anomalous pancreaticobiliary junction.
OBJECTIVE
To evaluate conditions similar to those of carcinogenesis of the gallbladder between the gallbladder with a low junction of the cystic duct (LJCD) and an anomalous pancreaticobiliary junction (APBJ).


METHODS
Retrospective and clinicopathological analysis of patients with gallbladder carcinoma.


METHODS
First Department of Surgery, Kansai Medical University.


METHODS
Examination of 47 patients (7 men and 40 women; average age: 67.8 years) with gallbladder carcinoma revealed 7 patients (14.9%; 1 man and 6 women; average age: 67.8 years) with LJCD and 6 patients (12.8%; 6 women; average age: 60.3 years) with APBJ.


METHODS
Clinical findings in both groups were compared with those of the 34 patients who remained after exclusion of the data of the above 7 patients with LJCD and 6 patients with APBJ. The data of the three groups were examined by the chi 2 test at the 5% level of significance.


RESULTS
Most of the gallbladder cancer patients with LJCD or APBJ had gallstones. The biliary amylase levels determined in the gallbladder of patients with LJCD or APBJ were remarkably high.


CONCLUSIONS
The results indicate that patients with LJCD or APBJ are more likely to develop carcinoma of the gallbladder. The factors responsible for carcinogenesis may be alteration of the bile content due to reflux of pancreatic enzymes through the LJCD or APBJ, and mechanical irritation due to gallstones. Therefore, these pathological conditions in patients with LJCD are similar to those experienced in patients with APBJ.
Uetsuji
S
S
First Department of Surgery, Kansai Medical University, Osaka, Japan.
Okuda
Y
Y
Kwon
A H
AH
Komada
H
H
Imamura
A
A
Takai
S
S
Kamiyama
Y
Y
D000368:Aged; D000681:Amylases / Q000378:metabolism; D002769:Cholelithiasis / Q000453:epidemiology; D003135:Common Bile Duct / Q000002:abnormalities*; D003549:Cystic Duct / Q000002:abnormalities*; D005260:Female; D005706:Gallbladder Neoplasms / Q000201:enzymology / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000002:abnormalities*; D012189:Retrospective Studies; D012307:Risk Factors
D000681:Amylases