Gallbladder cancer with a low junction of the cystic duct or an anomalous pancreaticobiliary junction
Gallbladder cancer with a low junction of the cystic duct or an anomalous pancreaticobiliary junction
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胆囊癌伴有胆囊管低位连接或胰胆连接处异常
DOI：
10.1097/00042737-199612000-00015
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发表时间：
1996
期刊：
影响因子：
--
通讯作者：
Yasuo Kamiyama
中科院分区：
文献类型：
--
作者：
S. Uetsuji;Y. Okuda;A. Kwon;H. Komada;A. Imamura;S. Takai;Yasuo Kamiyama
目的：探讨胆囊管低位结合部(LJCD)与异常胰胆管结合部(APBJ)之间发生胆囊癌的条件。设计：回顾分析胆囊癌患者的临床病理资料。单位：关西医科大学第一外科。患者：47例胆囊癌患者(男7例，女40例；平均年龄67.8岁)检查发现7例(14.9%；男1例，女6例；平均年龄：67.8岁)LJCD和6例(12.8%；6女，平均年龄：60.3岁)APBJ。方法：将两组患者的临床资料与排除上述7例LJCD和6例APBJ后留下来的34例患者的临床表现进行比较。3组数据经χ-2检验，均达到5%显著水平。结果：胆囊癌合并LJCD或APBJ患者以胆结石居多。LJCD和APBJ患者的胆汁淀粉酶水平明显升高。结论：LJCD或APBJ患者更易发生胆囊癌。致癌因素可能是胰酶通过LJCD或APBJ回流引起胆汁含量的改变，以及胆结石引起的机械刺激。因此，LJCD患者的这些病理状态与APBJ患者所经历的相似。欧洲胃肠病与肝病杂志1996，8：1213-1217
Objective: To evaluate conditions similar to those of carcinogenesis of the gallbladder between the gallbladder with a low junction of the cystic duct (LJCD) and an anomalous pancreaticobiliary junction (APBJ). Design: Retrospective and clinicopathological analysis of patients with gallbladder carcinoma. Setting: First Department of Surgery, Kansai Medical University. Patients: Examination of 47 patients (7 men and 40 women; average age: 67.8 years) with gallbladder carcinoma revealed 7 patients (14.9%; 1 man and 6 women; average age: 67.8 years) with LJCD and 6 patients (12.8%; 6 women; average age: 60.3 years) with APBJ. Methods: Clinical findings in both groups were compared with those of the 34 patients who remained after exclusion of the data of the above 7 patients with LJCD and 6 patients with APBJ. The data of the three groups were examined by the χ2 test at the 5% level of significance. Results: Most of the gallbladder cancer patients with LJCD or APBJ had gallstones. The biliary amylase levels determined in the gallbladder of patients with LJCD or APBJ were remarkably high. Conclusion: The results indicate that patients with LJCD or APBJ are more likely to develop carcinoma of the gallbladder. The factors responsible for carcinogenesis may be alteration of the bile content due to reflux of pancreatic enzymes through the LJCD or APBJ, and mechanical irritation due to gallstones. Therefore, these pathological conditions in patients with LJCD are similar to those experienced in patients with APBJ. European Journal of Gastroenterology & Hepatology 1996, 8:1213–1217