Xiang Yukai, Qiu Chen, Hu Hai, Cai Jingli, Zhao Gang, Huang Anhua, Xu Anan, He Chuanqi, Zhang Cheng, Yang Yulong, Jiang Zhaoyan
Center of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, School of Medicine, Tongji University, Shanghai, 200092, China.
BMC Gastroenterol. 2025 Jul 30;25(1):542. doi: 10.1186/s12876-025-04131-3.
This study aimed to elucidate the clinical characteristics of occult pancreaticobiliary reflux (OPBR) in benign gallbladder diseases, including gallbladder stone (GS), gallbladder polyp (GP), and gallbladder adenomyomatosis (GA).
We studied 578 patients with a normal pancreaticobiliary junction undergoing surgery for gallbladder diseases between December 2020 and January 2022. Of these, 80 patients had elevated bile amylase levels (> 110U/L) and were classified as OPBR patients; 498 comprised the control group. Patients fell into four groups: Group A (GA), Group B (GS alone), Group C (GS and GP), and Group D (GP alone).
OPBR occurred in 16.2% of GS cases, 7.2% of GP cases, and 20.3% of GA cases. Patients with OPBR were typically older and more likely to have GS but less likely to have GP. In GS patients, OPBR incidence correlated with stone size, peaking at 48% in cases of gallbladder sludge (< 3 mm). OPBR incidence was highest in Group A (20.3%), followed by Group B (16.6%), Group C (8.9%), and Group D (4.8%). Patients over 50 and those in Groups A and B faced higher OPBR risk. In Group A, gallbladder sludge and hyper-gamma-glutamyltransferase were risk factors, while in Group B, gallbladder sludge and age over 50 were risk factors. No specific features associated with OPBR were found in Groups C and D.
In conclusion, GP isn't associated with OPBR, irrespective of GS presence. However, in GS alone or GA patients, gallbladder sludge should raise OPBR concerns, necessitating tailored clinical attention.
本研究旨在阐明隐匿性胰胆反流（OPBR）在良性胆囊疾病中的临床特征，这些疾病包括胆囊结石（GS）、胆囊息肉（GP）和胆囊腺肌症（GA）。
我们研究了2020年12月至2022年1月期间578例行胆囊疾病手术且胰胆管连接处正常的患者。其中，80例患者胆汁淀粉酶水平升高（>110U/L），被分类为OPBR患者；498例组成对照组。患者分为四组：A组（GA）、B组（单纯GS）、C组（GS和GP）和D组（单纯GP）。
OPBR在GS病例中的发生率为16.2%，在GP病例中的发生率为7.2%，在GA病例中的发生率为20.3%。OPBR患者通常年龄较大，更易患GS，但患GP的可能性较小。在GS患者中，OPBR发生率与结石大小相关，胆囊泥沙样结石（<3mm）病例中发生率最高达48%。OPBR发生率在A组最高（20.3%），其次是B组（16.6%）、C组（8.9%）和D组（4.8%）。50岁以上患者以及A组和B组患者面临更高的OPBR风险。在A组中，胆囊泥沙样结石和高γ-谷氨酰转移酶是危险因素，而在B组中，胆囊泥沙样结石和50岁以上年龄是危险因素。在C组和D组中未发现与OPBR相关的特定特征。
总之，无论是否存在GS，GP均与OPBR无关。然而，在单纯GS或GA患者中，胆囊泥沙样结石应引起对OPBR的关注，需要进行针对性的临床关注。
