Effect of pancreatic biliary reflux as a cofactor in cholecystitis.
This study assessed the effect of pancreatico-biliary reflux (PBR) as co-factor in the process of chronic cholecystitis by measurement of the levels of active pancreatic enzyme amylase in gallbladder bile and serum of patients undergoing cholecystectomy. Pancreatic Amylase levels in bile from the gallbladder and serum were measured during surgery in 68 patients with chronic calcular cholecystitis subjected to elective open or laparoscopic cholecystectomy in the National Hepatology and Tropical Medicine Research Institution and Theodore Bilharz Research Institute. Bile amylase was detected in 64 patients (94.1%) indicating pancreatico-biliary reflux. Biliary amylase level ranged from 20-50 IU/L in 42 patients (61.76%), below 20 IU/l in 14 patients (20.59%), over 50 IU/L in 8 patients (11.76%) and undetectable in two patients. According to gallbladder bile amylase, the incidence of Occult PBR in patients operated upon for chronic calcular cholecystitis was 94.1%. The reason should be clarified by further research and wider scale study. Routinely investigating biliary amylase in every patient having cholecystitis can be a method for early detection of precancerous lesions.
Department of General Surgery, National Hepatology and Tropical Medicine Research Institution, Imbaba POB 30, Gizal2411, Egypt.
Abdel Raouf
AR
Amr
Hussam Mohamed
HM
Hamdy
Magid Mahmoud
MM
Nasr
Mohammed Saied
MS
Hedaya
Ahmed Mohamed Abdelaziz
AM
Hassan
D000328:Adult; D001655:Bile Reflux / Q000209:etiology*; D002764:Cholecystitis / Q000150:complications* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000209:etiology*