Pancreatobiliary reflux and the length of a common channel
Pancreatobiliary reflux and the length of a common channel
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DOI：
10.1007/s00534-010-0282-4
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发表时间：
2010-11-01
影响因子：
3
通讯作者：
Takehara, Hiroo
中科院分区：
文献类型：
--
作者：
Kamisawa, Terumi;Suyama, Masafumi;Takehara, Hiroo
胆囊癌经常发生在由于胰腺反流而导致的胰腺胆管疾病不当的患者中。在一些相对较长的公共通道的患者中，还检测到胰腺反流。这项研究旨在阐明胰腺反流与公共通道的长度之间的相关性。两十三个患者，其中测量了胆汁中公共通道的长度和淀粉酶水平的长度，从9个中心纳入。水平与公共通道的长度相关（p <0.01）。可以在胆汁中诱导明显升高的淀粉酶水平的公共通道的最小长度（> 1,000 mg/dl）确定为5 mm。我们重新定义了胰腺管道（HCPBD）的高汇合度为具有公共通道A零件每千元5 mm的病例，其中胰腺导管和胆管之间的通信被括约肌收缩闭塞。在56例重新定义的HCPBD患者中，有20％发现了胆囊癌。在79％和95％的患者中检测到胆汁淀粉酶水平> 1,000 mg/dl和胆汁氢酶反流，应监测公共通道A零件A零件A零件的患者（重新定义HCPBD），以监测Gallbladder Cancel的发育，以示监测他们经常显示出明显的胰腺反流。
Gallbladder cancer occurs frequently in patients with pancreaticobiliary maljunction due to pancreatobiliary reflux. Pancreatobiliary reflux is also detected in some patients with a relatively long common channel. This study aimed to clarify the correlation between pancreatobiliary reflux and the length of a common channel.Two hundred and three patients, in whom both the length of a common channel and amylase level in the bile were measured, were enrolled from nine centers.Bile amylase level was correlated with the length of a common channel (P < 0.01). The minimum length of a common channel that could induce a markedly elevated amylase level in the bile (> 1,000 mg/dl) was determined as 5 mm. We redefined high confluence of pancreatobiliary ducts (HCPBD) as cases with a common channel a parts per thousand yen5 mm, in which the communication between the pancreatic and bile ducts was occluded with the sphincter contraction. Gallbladder cancer was found in 20% of 56 redefined HCPBD patients. Bile amylase level > 1,000 mg/dl and biliopancreatic reflux were detected in 79 and 95% of the patients, respectively.Patients with a common channel a parts per thousand yen5 mm (redefined HCPBD) should be monitored for the development of gallbladder cancer, as they frequently showed significant pancreatobiliary reflux.