title: Clinical study of choledochocele: is it a risk factor for biliary malignancies?
abstract: BACKGROUND
  We aimed to clarify the clinical characteristics of choledochocele and to evaluate the possibility of choledochocele as a risk factor for biliary malignancies.
  
  
  METHODS
  The clinical feature, the configuration of the pancreatobiliary ductal system, coexistent pancreatobiliary lesions, and amylase level in bile in 21 patients with choledochocele were reviewed. The correlation between the configuration, comorbid diseases, and amylase level in the bile was investigated.
  
  
  RESULTS
  There was a female predominance, and 57% of the patients showed abdominal pain. Quite a few patients showed elevation of the levels of hepatobiliary enzymes. The configuration of the pancreatobiliary ductal system and choledochocele was classified into two categories: type I, where the choledochocele and pancreatic duct were visualized independently or simultaneously (90.5%); and type II, where the pancreatic duct was visualized after filling of the choledochocele (9.5%). Among coexistent bilio-pancreatic diseases, biliary stone diseases were the most frequent. Biliary malignancy was seen in 3 patients (14.3%). The amylase level in the bile was high in 50% (4/8) of the patients examined. The rate of abnormal elevation of amylase level in the bile in the two types of pancreatobiliary ductal system and choledochocele was 3/7 and 1/1, respectively.
  
  
  CONCLUSIONS
  The prevalence of organic abnormal arrangement of the pancreatobiliary ductal system in which the choledochocele serves as a common channel is low. However, there are patients with suspected functional abnormal arrangement of the pancreatobiliary ductal system, who may possibly be a high-risk group for biliary malignancy.
authors.affiliation: Department of Gastroenterology, Sendai City Medical Center, 5-22-1 Tsurugaya, Miyagino-ku, Sendai 983-0824, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Horaguchi
authors.forename: Naotaka
authors.initials: N
authors.lastname: Fujita
authors.forename: Go
authors.initials: G
authors.lastname: Kobayashi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Noda
authors.forename: Kei
authors.initials: K
authors.lastname: Ito
authors.forename: Osamu
authors.initials: O
authors.lastname: Takasawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000097:blood; D000681:Amylases / Q000097:blood*; D001646:Bile / Q000201:enzymology*; D001661:Biliary Tract Neoplasms / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D018395:CA-19-9 Antigen / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood; D002760:Cholangiopancreatography, Endoscopic Retrograde; D015529:Choledochal Cyst / Q000150:complications* / Q000000981:diagnostic imaging / Q000378:metabolism; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D015415:Biomarkers; D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen; D005723:gamma-Glutamyltransferase; D000469:Alkaline Phosphatase; D000681:Amylases