Gallbladder carcinoma associated with pancreatobiliary reflux.
OBJECTIVE
To detect the patients with and without pancreaticobiliary 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 (>10000 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 10000 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.


CONCLUSIONS
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.
Sai
Jin Kan
JK
Department of Gastroenterology, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan. jinkans@med.juntendo.ac.jp
Suyama
Masafumi
M
Kubokawa
Yoshihiro
Y
Nobukawa
Bunsei
B
D000328:Adult; D000368:Aged; D000681:Amylases / Q000032:analysis; D001652:Bile Ducts / Q000000981:diagnostic imaging / Q000473:pathology; D001655:Bile Reflux / Q000209:etiology* / Q000473:pathology; D002277:Carcinoma / Q000150:complications* / Q000473:pathology; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D005706:Gallbladder Neoplasms / Q000150:complications* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology; D011446:Prospective Studies; D014463:Ultrasonography
D000681:Amylases