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Pancreatobiliary reflux in individuals with a normal pancreaticobiliary junction: a prospective multicenter study

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

Background

Pancreatobiliary reflux (PBR) can occur in individuals without pancreaticobiliary maljunction. The aim of this study was to elucidate the incidence of PBR in individuals with a normal pancreaticobiliary junction and its impact on the biliary tree.

Methods

Data were prospectively collected from 15 centers on 420 patients with a morphologically normal pancreaticobiliary junction who had undergone bile sampling and measurement of the biliary amylase level. We investigated the incidence and predictive factors for high biliary amylase levels (HBAL), as well as the relationship of HBAL with biliary malignancy.

Results

Twenty-three patients (5.5 %) showed HBAL (≥10,000 IU/L). Univariate analysis showed that risk factors for the elevation of biliary amylase levels were the existence of a relatively long common channel (≥5 mm), acute pancreatitis, and papillitis. Multivariate analysis revealed that only the existence of a relatively long common channel was a significant factor for PBR. Biliary amylase levels in patients with a relatively long common channel were significantly higher than in patients without a long common channel (12,333 vs. 2,070 IU/L, P = 0.001). The incidence of HBAL (P < 0.001), as well as the overall biliary amylase levels (P = 0.007) were significantly higher in patients with gallbladder cancer than in those without gallbladder cancer.

Conclusions

The PBR was frequently observed in individuals with a relatively long common channel. Patients showing HBAL with normal pancreaticobiliary junction are at high risk for gallbladder cancer.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Gastroenterology, Sendai City Medical Center, 5-22-1 Tsurugaya, Miyagino-ku, Sendai, Miyagi, 983-0824, Japan

    Jun Horaguchi & Naotaka Fujita

  2. Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan

    Terumi Kamisawa

  3. Department of Surgery, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan

    Goro Honda

  4. Surgical Oncology and Regulation of Organ Function, Miyazaki University School of Medicine, Miyazaki, Japan

    Kazuo Chijiiwa

  5. Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan

    Hiroyuki Maguchi

  6. Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Masao Tanaka

  7. Department of Surgery, The University of Tokushima Graduate School, Tokushima, Japan

    Mitsuo Shimada

  8. Department of Gastroenterology and Hepatology, Toho University Omori Medical Center, Tokyo, Japan

    Yoshinori Igarashi

  9. Department of Gastroenterology, Second Teaching Hospital Fujita Health University, Nagoya, Japan

    Kazuo Inui

  10. Center for Gastroendoscopy, Onomichi General Hospital, Onomichi, Japan

    Keiji Hanada

  11. Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan

    Takao Itoi

  12. Department of Pediatric Surgery, Kansai Medical University, Moriguchi, Japan

    Yoshinori Hamada

  13. Division of Pediatric Surgery, Department of Surgery, Nihon University School of Medicine, Tokyo, Japan

    Tsugumichi Koshinaga

  14. First Department of Surgery, University of Yamanashi, Yamanashi, Japan

    Hideki Fujii

  15. Department of Pediatric Surgery, Shizuoka Children’s Hospital, Shizuoka, Japan

    Naoto Urushihara

  16. Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Hisami Ando

Authors
  1. Jun Horaguchi
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  2. Naotaka Fujita
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  3. Terumi Kamisawa
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  4. Goro Honda
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  5. Kazuo Chijiiwa
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  6. Hiroyuki Maguchi
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  7. Masao Tanaka
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  8. Mitsuo Shimada
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  9. Yoshinori Igarashi
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  10. Kazuo Inui
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  11. Keiji Hanada
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  12. Takao Itoi
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  13. Yoshinori Hamada
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  14. Tsugumichi Koshinaga
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  15. Hideki Fujii
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  16. Naoto Urushihara
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  17. Hisami Ando
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Consortia

The committee of Diagnostic Criteria of The Japanese Study Group on Pancreaticobiliary Maljunction

Corresponding author

Correspondence to Jun Horaguchi.

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Horaguchi, J., Fujita, N., Kamisawa, T. et al. Pancreatobiliary reflux in individuals with a normal pancreaticobiliary junction: a prospective multicenter study. J Gastroenterol 49, 875–881 (2014). https://doi.org/10.1007/s00535-013-0837-7

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  • DOI: https://doi.org/10.1007/s00535-013-0837-7

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