Sai Jin Kan, Suyama Masafumi, Kubokawa Yoshihiro, Nobukawa Bunsei
Department of Gastroenterology, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
World J Gastroenterol. 2006 Oct 28;12(40):6527-30. doi: 10.3748/wjg.v12.i40.6527.
To detect the patients with and without pancreaticobiliary maljunction who had pancreatobiliary reflux with extremely high biliary amylase levels.
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.
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.
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.
检测存在和不存在胰胆合流异常且伴有胆汁淀粉酶水平极高的胰胆反流患者。
对96例胆囊壁弥漫性增厚（>3mm）且超声检查怀疑有胰胆合流异常的患者进行前瞻性内镜逆行胰胆管造影，并采集胆总管胆汁样本。其中，胆汁淀粉酶水平极高（>10000IU/L）的患者接受胆囊切除术，并检查有无胰胆合流异常患者的临床病理结果。
17例患者胆总管胆汁淀粉酶水平高于10000IU/L，其中11例有胰胆合流异常，6例无胰胆合流异常。有胰胆合流异常患者的胆囊癌发生率为45.5%（5/11），无胰胆合流异常患者为50%（3/6）。
在存在和不存在胰胆合流异常的患者中均可发现胆汁淀粉酶水平极高且伴有胆囊癌的胰胆反流，这些患者可通过超声检查和胆汁采样进行检测。
