Pancreatobiliary reflux in individuals with a normal pancreaticobiliary junction: a prospective multicenter study

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• 作者：Jun Horaguchi (1)
  Naotaka Fujita (1)
  Terumi Kamisawa (2)
  Goro Honda (3)
  Kazuo Chijiiwa (4)
  Hiroyuki Maguchi (5)
  Masao Tanaka (6)
  Mitsuo Shimada (7)
  Yoshinori Igarashi (8)
  Kazuo Inui (9)
  Keiji Hanada (10)
  Takao Itoi (11)
  Yoshinori Hamada (12)
  Tsugumichi Koshinaga (13)
  Hideki Fujii (14)
  Naoto Urushihara (15)
  Hisami Ando (16)
  
• 关键词：Pancreatobiliary reflux ; Normal pancreaticobiliary junction ; Gallbladder cancer ; Long common channel
• 刊名：Journal of Gastroenterology
• 出版年：2014
• 出版时间：May 2014
• 年：2014
• 卷：49
• 期：5
• 页码：875-881
• 全文大小：
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• 作者单位：Jun Horaguchi (1)
  Naotaka Fujita (1)
  Terumi Kamisawa (2)
  Goro Honda (3)
  Kazuo Chijiiwa (4)
  Hiroyuki Maguchi (5)
  Masao Tanaka (6)
  Mitsuo Shimada (7)
  Yoshinori Igarashi (8)
  Kazuo Inui (9)
  Keiji Hanada (10)
  Takao Itoi (11)
  Yoshinori Hamada (12)
  Tsugumichi Koshinaga (13)
  Hideki Fujii (14)
  Naoto Urushihara (15)
  Hisami Ando (16)
  
  1. Department of Gastroenterology, Sendai City Medical Center, 5-22-1 Tsurugaya, Miyagino-ku, Sendai, Miyagi, 983-0824, Japan
  2. Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan
  3. Department of Surgery, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan
  4. Surgical Oncology and Regulation of Organ Function, Miyazaki University School of Medicine, Miyazaki, Japan
  5. Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
  6. Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  7. Department of Surgery, The University of Tokushima Graduate School, Tokushima, Japan
  8. Department of Gastroenterology and Hepatology, Toho University Omori Medical Center, Tokyo, Japan
  9. Department of Gastroenterology, Second Teaching Hospital Fujita Health University, Nagoya, Japan
  10. Center for Gastroendoscopy, Onomichi General Hospital, Onomichi, Japan
  11. Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
  12. Department of Pediatric Surgery, Kansai Medical University, Moriguchi, Japan
  13. Division of Pediatric Surgery, Department of Surgery, Nihon University School of Medicine, Tokyo, Japan
  14. First Department of Surgery, University of Yamanashi, Yamanashi, Japan
  15. Department of Pediatric Surgery, Shizuoka Children’s Hospital, Shizuoka, Japan
  16. Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
  
• ISSN：1435-5922

文摘

Background Pancreatobiliary reflux (PBR) can occur in individuals without pancreaticobiliary maljunction. The aim of this study was to elucidate the incidence of PBR in individuals with a normal pancreaticobiliary junction and its impact on the biliary tree. Methods Data were prospectively collected from 15 centers on 420 patients with a morphologically normal pancreaticobiliary junction who had undergone bile sampling and measurement of the biliary amylase level. We investigated the incidence and predictive factors for high biliary amylase levels (HBAL), as well as the relationship of HBAL with biliary malignancy. Results Twenty-three patients (5.5?%) showed HBAL (?0,000?IU/L). Univariate analysis showed that risk factors for the elevation of biliary amylase levels were the existence of a relatively long common channel (??mm), acute pancreatitis, and papillitis. Multivariate analysis revealed that only the existence of a relatively long common channel was a significant factor for PBR. Biliary amylase levels in patients with a relatively long common channel were significantly higher than in patients without a long common channel (12,333 vs. 2,070?IU/L, P?=?0.001). The incidence of HBAL (P?<?0.001), as well as the overall biliary amylase levels (P?=?0.007) were significantly higher in patients with gallbladder cancer than in those without gallbladder cancer. Conclusions The PBR was frequently observed in individuals with a relatively long common channel. Patients showing HBAL with normal pancreaticobiliary junction are at high risk for gallbladder cancer.