title: Pancreatobiliary reflux and the length of a common channel.
abstract: OBJECTIVE
  Gallbladder cancer occurs frequently in patients with pancreaticobiliary maljunction due to pancreatobiliary reflux. Pancreatobiliary reflux is also detected in some patients with a relatively long common channel. This study aimed to clarify the correlation between pancreatobiliary reflux and the length of a common channel.
  
  
  METHODS
  Two hundred and three patients, in whom both the length of a common channel and amylase level in the bile were measured, were enrolled from nine centers.
  
  
  RESULTS
  Bile amylase level was correlated with the length of a common channel (P < 0.01). The minimum length of a common channel that could induce a markedly elevated amylase level in the bile (>1,000 mg/dl) was determined as 5 mm. We redefined high confluence of pancreatobiliary ducts (HCPBD) as cases with a common channel > or = 5 mm, in which the communication between the pancreatic and bile ducts was occluded with the sphincter contraction. Gallbladder cancer was found in 20% of 56 redefined HCPBD patients. Bile amylase level >1,000 mg/dl and biliopancreatic reflux were detected in 79 and 95% of the patients, respectively.
  
  
  CONCLUSIONS
  Patients with a common channel > or = 5 mm (redefined HCPBD) should be monitored for the development of gallbladder cancer, as they frequently showed significant pancreatobiliary reflux.
authors.affiliation: Department of Internal Medicine, Tokyo Metropolitan, Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan. kamisawa@cick.jp
authors.forename: Terumi
authors.initials: T
authors.lastname: Kamisawa
authors.forename: Masafumi
authors.initials: M
authors.lastname: Suyama
authors.forename: Naotaka
authors.initials: N
authors.lastname: Fujita
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Maguchi
authors.forename: Keiji
authors.initials: K
authors.lastname: Hanada
authors.forename: Seiyo
authors.initials: S
authors.lastname: Ikeda
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Igarashi
authors.forename: Takao
authors.initials: T
authors.lastname: Itoi
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Kida
authors.forename: Goro
authors.initials: G
authors.lastname: Honda
authors.forename: Jinkan
authors.initials: J
authors.lastname: Sai
authors.forename: Jun
authors.initials: J
authors.lastname: Horaguchi
authors.forename: Kuniyuki
authors.initials: K
authors.lastname: Takahashi
authors.forename: Takamitsu
authors.initials: T
authors.lastname: Sasaki
authors.forename: Kensuke
authors.initials: K
authors.lastname: Takuma
authors.forename: Fumihide
authors.initials: F
authors.lastname: Itokawa
authors.forename: Hisami
authors.initials: H
authors.lastname: Ando
authors.forename: Hiroo
authors.initials: H
authors.lastname: Takehara
mesh_terms: D000681:Amylases / Q000032:analysis; D001646:Bile / Q000201:enzymology; D001655:Bile Reflux / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003135:Common Bile Duct / Q000002:abnormalities*; D003937:Diagnosis, Differential; D005260:Female; D005706:Gallbladder Neoplasms / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism; D010183:Pancreatic Ducts / Q000002:abnormalities*; D012372:ROC Curve; D012307:Risk Factors
chemical_list: D000681:Amylases