Chang L Y, Wang H P, Wu M S, Huang H T, Wang H H, Lin C C, Lin J T
Department of Internal Medicine, National Taiwan University Hospital, Taipei, ROC.
Hepatogastroenterology. 1998 Nov-Dec;45(24):2016-9.
BACKGROUND/AIMS: Anomalous pancreaticobiliary ductal union (APBDU) has been proposed as a risk factor of gallbladder cancer. To clarify the frequency and the subtype distribution of APBDU in patients with gallbladder cancer and adenomyomatosis, a retrospective study was performed.
The radiograms of endoscopic retrograde cholangiopancreaticography of 680 patients with well-documented biliary and pancreatic ducts from April 1992 to November 1996 were reviewed. The length of the common channel and insertion of the pancreatic duct and the bile duct were identified and recorded.
Gallbladder cancer and adenomyomatosis were identified in 8 and 12 patients, respectively. Patients with gallbladder cancer were significantly older (mean age: 66.5 years, p<0.01) than those with gallbladder adenomyomatosis (mean age: 42.7 years). APBDU was noted in 59 (8.7%) of 680 cases with complete pancreaticobiliary radiograms. Among them, 5 of 8 patients with gallbladder cancer coexisted with APBDU. Four (80%) belonged to the P-B type. Six of 12 patients with gallbladder adenomyomatosis had APBDU. Five (83.3%) belonged to P-B type.
Patients with gallbladder cancer and adenomyomatosis were frequently associated with APBDU. The close relationship and similar distribution of the P-B type of APBDU in both diseases suggest an etiologic association in various gallbladder diseases.
背景/目的：胰胆管汇合异常（APBDU）被认为是胆囊癌的一个危险因素。为明确胆囊癌和腺肌增生症患者中APBDU的发生率及亚型分布，进行了一项回顾性研究。
回顾了1992年4月至1996年11月间680例有完整胆管和胰管造影记录患者的内镜逆行胰胆管造影（ERCP）影像。确定并记录共同通道的长度以及胰管和胆管的汇入情况。
分别在8例和12例患者中发现了胆囊癌和腺肌增生症。胆囊癌患者（平均年龄：66.5岁，p<0.01）比胆囊腺肌增生症患者（平均年龄：42.7岁）年龄显著更大。在680例有完整胰胆管造影的病例中，59例（8.7%）发现有APBDU。其中，8例胆囊癌患者中有5例合并APBDU。4例（80%）属于胰管-胆管（P-B）型。12例胆囊腺肌增生症患者中有6例有APBDU。5例（83.3%）属于P-B型。
胆囊癌和腺肌增生症患者常合并APBDU。两种疾病中P-B型APBDU的密切关系和相似分布提示在各种胆囊疾病中存在病因学关联。
