| 共同演者 |
Kamisawa Terumi（Department of Gastroenterology, Tokyo Metropolitan Komagome Hospital, Japan）, Kuruma Sawako（Department of Gastroenterology, Tokyo Metropolitan Komagome Hospital, Japan）, Tabata Taku（Department of Gastroenterology, Tokyo Metropolitan Komagome Hospital, Japan）, Chiba Kazuro（Department of Gastroenterology, Tokyo Metropolitan Komagome Hospital, Japan）, Kuwata Go（Department of Gastroenterology, Tokyo Metropolitan Komagome Hospital, Japan）, Egashira Hideto（Department of Gastroenterology, Tokyo Metropolitan Komagome Hospital, Japan）, Fujiwara Takashi（Department of Gastroenterology, Tokyo Metropolitan Komagome Hospital, Japan）, Koizumi Koichi（Department of Gastroenterology, Tokyo Metropolitan Komagome Hospital, Japan）, Fujiwara Junko（Department of Endoscopy, Tokyo Metropolitan Komagome Hospital, Japan）, Arakawa Takeo（Department of Endoscopy, Tokyo Metropolitan Komagome Hospital, Japan）, Momma Kumiko（Department of Endoscopy, Tokyo Metropolitan Komagome Hospital, Japan）, Kurata Masanao（Department of Surgery, Tokyo Metropolitan Komagome Hospital, Japan）, Honda Goro（Department of Surgery, Tokyo Metropolitan Komagome Hospital, Japan）, Igarashi Yoshinori（Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Omori Medical Center, Japan） |
| 抄録 |
Aim：In pancreaticobiliary maljunction（PBM）patients, since the pancreatic and bile ducts are joined outside the duodenal wall, the action of the sphincter of Oddi does not functionally affect the junction, resulting in continuous pancreatobiliary reflux and biliary carcinoma. Pancreatobiliary reflux is also detected in some patients with a relatively long common channel（High confluence of pancreatobiliary ducts（HCPBD）with a common channel＞6 mm）. This study aimed to clarify the correlation pancreatobiliary reflux and biliary carcinoma. Methods：We examined clinicopathological findings of 109 PBM and 95 HCPBD patients. Results：Although PBM occurred predominantly in females（male/female ratio：0.3）, there was no difference between genders in HCPBD patients（1.2）. In 53 PBM patients with biliary dilatation, the bile duct and gallbladder carcinoma was seen in 21% and 17%, respectively. In 56 PBM patients without biliary dilation, only gallbladder carcinoma was detected in 68%. Gallbladder carcinoma was associated with 12% of HCPBD patients. The amylase level in the bile was elevated in HCPBD and PBM patients（average 19450 IU/l vs. 255950 IU/l）. Hyperplastic change and K-ras mutations of the gallbladder mucosa were detected in both patients. Conclusions：Pancreatobiliary reflux and premalignant changes in the gallbladder can occur in HCPBD patients as well as in PBM patients. Further study is necessary to determine the clinical implications of pancreatobiliary reflux. |
