Amylase level in extrahepatic bile duct in adult patients with choledochal cyst plus anomalous pancreatico-biliary ductal union.
OBJECTIVE
To investigate the relationship between pancreatic amylase in bile duct and the clinico-pathological features in adult patients with choledochal cyst and anomalous pancreatico-biliary ductal union (APBDU).


METHODS
From 39 patients who underwent surgery for choledochal cyst between March 1995 and March 2003, we selected 15 adult patients who had some symptoms and were radiologically diagnosed as APBDU, and their clinico-pathological features were subsequently evaluated retrospectively. However, we could not obtain biliary amylase in all the patients because of the surgeon's slip. Therefore, we measured the amylase level in gall bladder of 10 patients and in common bile duct of 11 patients.


RESULTS
Levels of amylase in common bile duct and gall bladder ranged from 11,500 to 212,000 IU/L, and the younger the patients, the higher the biliary amylase level (r = -0.982, P<0.01). Pathologically, significant correlation was found between the size of choledochal cyst and the grade of inflammation (r = 0.798, P<0.01). And, significant correlation was found between the level of amylase in gall bladder and the grade of hyperplasia. On the other hand, there was no correlation to the age of symptomatic onset or inflammatory grade (r = 0.743, P<0.05). Level of lipase was elevated from 6,000 to 159,000 IU/L in bile duct and from 14,400 to 117,000 IU/L in the gall bladder; however, there was no significant correlation with age or clinico-pathological features.


CONCLUSIONS
The results support the notion that amylase has a particular role in the onset of symptoms, and suggest that a large amount of biliary amylase induces early onset of symptom, thereby making early diagnosis possible.
Jeong
In-Ho
IH
Department of Surgery, Ajou University School of Medicine, Wonchondong, Yeongtonggu, Suwon 442-749, Korea.
Jung
Yong-Sik
YS
Kim
Hong
H
Kim
Bong-Wan
BW
Kim
Jung-Woon
JW
Hong
Jeong
J
Wang
Hee-Jung
HJ
Kim
Myung-Wook
MW
Yoo
Byung-Moo
BM
Kim
Jin-Hong
JH
Han
Jae-Ho
JH
Kim
Wook-Hwan
WH
D000328:Adult; D000681:Amylases / Q000378:metabolism*; D015529:Choledochal Cyst / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D003135:Common Bile Duct / Q000002:abnormalities* / Q000201:enzymology* / Q000473:pathology; D005260:Female; D006801:Humans; D006965:Hyperplasia; D008049:Lipase / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000002:abnormalities*; D012189:Retrospective Studies
D008049:Lipase; D000681:Amylases