Department of Surgery, Surgical Oncology and Science, Sapporo Medical University School of Medicine, 291 Minami-1-jo Nishi 16-chome, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan.
Department of Pediatric Surgery, Hokkaido Medical Center for Child Health and Rehabilitation, 1-1-240-6, Kanayama, Teine-ku, Sapporo, Hokkaido, 006-0041, Japan.
Pediatr Surg Int. 2024 Aug 5;40(1):215. doi: 10.1007/s00383-024-05799-6.
We investigated the relationship between bile amylase (AMY) levels and biliary epithelial changes in pancreaticobiliary maljunction (PBM), a congenital anomaly characterized by pancreaticobiliary reflux due to duct fusion outside the duodenal wall.
We enrolled 43 children with congenital biliary dilatation (CBD) of Todani types Ia, Ic, and IVa who underwent surgery at the Hokkaido Medical Center for Child Health and Rehabilitation between November 2007 and June 2023. We defined total AMY exposure in bile as bile AMY levels multiplied by the patient's age (months), representing amount of estimated AMY exposure until surgery. We retrospectively investigated the relationships between bile AMY levels and clinicopathological findings.
All patients exhibited hyperplasia in the gallbladder and bile duct epithelium, with dysplasia observed in 13 cases, but no carcinoma. Exposure to bile AMY ≥ 662,400 IU/L × months was an independent risk factor for dysplasia.
The amount of estimated AMY exposure in bile rather than AMY levels in the bile is an independent risk factor for dysplasia in the biliary mucosa.
我们研究了胆胰管汇合异常（PBM）中胆汁淀粉酶（AMY）水平与胆管上皮变化之间的关系，这种先天性异常的特征是由于十二指肠壁外的导管融合导致胰胆反流。
我们招募了 2007 年 11 月至 2023 年 6 月在北海道儿童健康与康复医疗中心接受手术的 43 例先天性胆管扩张（CBD）的 Todani 类型 Ia、Ic 和 IVa 的儿童。我们将胆汁中的总 AMY 暴露定义为胆汁 AMY 水平乘以患者的年龄（月），代表手术前估计的 AMY 暴露量。我们回顾性地研究了胆汁 AMY 水平与临床病理发现之间的关系。
所有患者均表现出胆囊和胆管上皮增生，13 例存在发育不良，但无癌。胆汁 AMY≥662,400 IU/L×月的暴露是发育不良的独立危险因素。
胆汁中估计的 AMY 暴露量而不是胆汁中的 AMY 水平是胆管黏膜发育不良的独立危险因素。
