Surgical Strategy for Patients with Pancreaticobiliary Maljunction without Choledocal Dilatation.

Funabiki, Takuzo; Matsubara, Toshiki; Ochiai, Masahiro; Marugami, Yoshihisa; Sakurai, Yoshinori; Hasegawa, Shigeru; Imazu, Hiroki

doi:10.2302/kjm.46.169

Cited by 39 publications

(30 citation statements)

References 16 publications

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“…So, from a viewpoint of prophylaxis against carcinogenesis, the extrahepatic bile duct has to be excised together with gallbladder, even for the patient with nondilated bile duct and PBM [49,72].…”

Section: Treatmentmentioning

confidence: 99%

Pancreaticobiliary maljunction and carcinogenesis to biliary and pancreatic malignancy

Funabiki

Matsubara²,

Miyakawa

et al. 2008

Langenbecks Arch Surg

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160

146

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Section: Treatmentmentioning

confidence: 99%

Pancreaticobiliary maljunction and carcinogenesis to biliary and pancreatic malignancy

Funabiki

Matsubara²,

Miyakawa

et al. 2008

Langenbecks Arch Surg

Self Cite

160

146

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“…The terms Pancreatico-Biliary Malunion, Pancreatico-Biliary Maljunction, Common Pancreatico-Biliary Channel Syndrome and Anomalous Pancreatico-Biliary Ductal Union were used interchangeably to signify the same anatomical abnormality of the connection between the pancreatic duct and the CBD [1,3,4,7,8]. In adults, an anomalous pancreaticobiliary ductal junction is defined as a common channel that is more than 15 mm in length or a contractile segment totally distal to the union of the biliary and pancreatic ducts [9].…”

Section: Discussionmentioning

confidence: 99%

“…The length of the common pancreaticobiliary channel was reported to be in the range between 1 and 12 mm with an average length of 4.4 mm [10,11]. The association between PBM and GB carcinoma has been documented in many reports [1,2,4,6,9,12]; however, there is apparently no information as to whether patients with PBM would still develop carcinoma of the GB if they have had an adequate drainage procedure.…”

Section: Discussionmentioning

confidence: 99%

“…Common pancreaticobiliary channel malunion (PBM) is known to be associated with increased frequency of gallbladder (GB) cancer [1]. The causal association was reported to be due to reflux of the pancreatic amylase into the bile duct and initiation of inflammatory changes in the GB, which eventually lead to malignant transformation in the GB.…”

Section: Introductionmentioning

confidence: 99%

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Chronic inflammatory changes seen in gallbladders of patients with pancreatico-biliary malunion years after transduodenal sphincterotomy: is it a precursor for gallbladder carcinoma?

2008

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Common pancreaticobiliary channel malunion (PBM) is known to be associated with increased frequency of gallbladder (GB) cancer in adults. Few studies have reported the presence of histological changes in the GB following transduodenal drainage procedures in children with PBM. The aim of this study was to document the histological changes in the GB in children who underwent interval prophylactic cholecystectomy up to 18 years following PBM drainage procedure. All children who underwent open transduodenal sphincterotomy (TDS) for symptomatic PBM followed by prophylactic synchronous (open) and interval (laparoscopic) cholecystectomy between 1987 and 2007 were studied retrospectively. Eight children with PBM were identified. The median age at initial presentation and open transduodenal sphincterotomy was 8 months (1 month-3.5 years). The average interval between open TDS and prophylactic cholecystectomy was 5.5 years (0-18 years). Two children had synchronous TDS and cholecystectomy. At initial presentation, all patients presented with obstructive jaundice. Mild common bile duct dilatation was encountered in all patients. The dilated ducts returned to normal, and remained normal after transduodenal sphincterotomy. Histopathology in seven out of eight GB specimens (87.5%) showed microscopic evidence of chronic inflammation. Chronic cholecystitis (n = 7), Rokitansky-Aschoff sinuses (n = 3), cholesterosis (n = 1) and intestinal metaplasia (n = 1) were observed in the GB biopsies. Only one patient, who had TDS and a synchronous cholecystectomy in the neonatal period, did not have histological changes in the GB. Average follow-up in years ranged between 3 months and 19 years (from TDS) with a median of 8 years, and between 3 months and 6 years (from cholecystectomy) with a median of 2 years. Chronic inflammatory changes were found in seven of eight GB specimens from patients with PBM despite previous drainage procedure in six patients and in one of two patients who underwent synchronous TDS and cholecystectomy. These changes may be the precursor of malignant transformation in GB of patients with PBM.

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“…A frequent association of biliary tract carcinoma and APBDU is well recognized [12][13][14][15][16][17][18][19] , especially in the undilated type APBDU [20,21] . Mori [7] had reported that among 698 patients subjected to endoscopic retrograde cholangiopancreatography, APBDU was found in 6 patients (0.9 %).…”

Section: Discussionmentioning

confidence: 99%

Bile from a patient with anomalous pancreaticobiliary ductal union promotes the proliferation of human cholangiocarcinoma cellsviaCOX-2 pathway

Zou²,

Liu³

et al. 2003

WJG

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AIM:To explore the effects of COX-2 gene in the proliferative activity induced by bile from anomalous pancreaticobiliary ductal union (APBDU) on human cholangiocarcinoma cell line. METHODS:Bile sample from APBDU and normal bile sample were used for this study. The proliferative effect of bile was measured by methabenzthiazuron (MTT) assay; COX-2 mRNA was examined by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR). Cell cycle was analyzed by flow cytometry (FCM), and the PGE 2 levels in the supernatant of cultured cholangiocarcinoma cells were quantitated by enzyme-linked immunoabsordent assay (ELISA). RESULTS:Bile from APBDU can significantly promote the proliferation of human cholangiocarcinoma QBC939 cells compared with normal bile (P=0.005) and upregulated remarkably their COX-2 mRNA expression (P=0.004). The proliferative activity of APBDU bile can be abolished by addition of cyclooxygenase-2 specific inhibitor celecoxib. CONCLUSION:Bile from APBDU can promote the proliferation of human cholangiocarcinoma QBC939 cells via COX-2 pathway.Wu GS, Zou SQ, Liu ZR, Wang DY. Bile from a patient with anomalous pancreaticobiliary ductal union promotes the proliferation of human cholangiocarcinoma cells via COX-2 pathway.

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Surgical Strategy for Patients with Pancreaticobiliary Maljunction without Choledocal Dilatation.

Cited by 39 publications

References 16 publications

Pancreaticobiliary maljunction and carcinogenesis to biliary and pancreatic malignancy

Pancreaticobiliary maljunction and carcinogenesis to biliary and pancreatic malignancy

Chronic inflammatory changes seen in gallbladders of patients with pancreatico-biliary malunion years after transduodenal sphincterotomy: is it a precursor for gallbladder carcinoma?

Bile from a patient with anomalous pancreaticobiliary ductal union promotes the proliferation of human cholangiocarcinoma cellsviaCOX-2 pathway

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