BACKGROUND/AIMS: Anomalous pancreaticobiliary junction is a rare anomaly but is a risk factor for primary carcinoma of the gallbladder. To define the relationship between anomalous pancreaticobiliary junction, especially if it is not associated with common bile duct dilatation, and gallbladder carcinoma, we retrospectively reviewed data of 126 patients with gallbladder carcinoma. METHODOLOGY: All these patients had undergone direct cholangiography either by endoscopic retrograde cholangiopancreaticography or percutaneous transhepatic cholangiography. RESULTS: Among 126 patients with gallbladder cancer, 23 patients (18.3%) exhibited anomalous pancreaticobiliary junction. Patients with anomalous pancreaticobiliary junction were younger (mean age: 54 +/- 9.1 years) than patients without anomalous pancreaticobiliary junction (mean age: 65 +/- 9.7 years). The incidence of gallstones in patients with anomalous pancreaticobiliary junction (17%) was significantly lower than in those without this anomaly (64%) (P < 0.01). Among the 23 patients with anomalous pancreaticobiliary junction, 12 patients (52%) had no bile duct dilatation and, 11 patients (48%) had bile duct dilatation in the form of fusiform or cylindrical dilatation. However, no cases with severe cystic dilatation were found. Patients of anomalous pancreaticobiliary junction without common bile duct dilatation had more advanced disease and poor prognosis than those with common bile duct dilatation. CONCLUSIONS: The present study revealed that gallbladder cancer in the patients of anomalous pancreaticobiliary junction without common bile duct dilatation was diagnosed at advanced stage and the prognosis was very poor. Therefore, if a minor abnormality is detected in the wall of acalculous gallbladder on ultrasonography, direct cholangiography should be done to exclude this anomaly.
BACKGROUND/AIMS: Anomalous pancreaticobiliary junction is a rare anomaly but is a risk factor for primary carcinoma of the gallbladder. To define the relationship between anomalous pancreaticobiliary junction, especially if it is not associated with common bile duct dilatation, and gallbladder carcinoma, we retrospectively reviewed data of 126 patients with gallbladder carcinoma. METHODOLOGY: All these patients had undergone direct cholangiography either by endoscopic retrograde cholangiopancreaticography or percutaneous transhepatic cholangiography. RESULTS: Among 126 patients with gallbladder cancer, 23 patients (18.3%) exhibited anomalous pancreaticobiliary junction. Patients with anomalous pancreaticobiliary junction were younger (mean age: 54 +/- 9.1 years) than patients without anomalous pancreaticobiliary junction (mean age: 65 +/- 9.7 years). The incidence of gallstones in patients with anomalous pancreaticobiliary junction (17%) was significantly lower than in those without this anomaly (64%) (P < 0.01). Among the 23 patients with anomalous pancreaticobiliary junction, 12 patients (52%) had no bile duct dilatation and, 11 patients (48%) had bile duct dilatation in the form of fusiform or cylindrical dilatation. However, no cases with severe cystic dilatation were found. Patients of anomalous pancreaticobiliary junction without common bile duct dilatation had more advanced disease and poor prognosis than those with common bile duct dilatation. CONCLUSIONS: The present study revealed that gallbladder cancer in the patients of anomalous pancreaticobiliary junction without common bile duct dilatation was diagnosed at advanced stage and the prognosis was very poor. Therefore, if a minor abnormality is detected in the wall of acalculous gallbladder on ultrasonography, direct cholangiography should be done to exclude this anomaly.
Authors: Takashi Muraki; Burcin Pehlivanoglu; Bahar Memis; Michelle D Reid; Takeshi Uehara; Olca Basturk; Jennifer Golia Pernicka; David S Klimstra; William R Jarnagin; Tetsuya Ito; Osamu Hasebe; Shinji Okaniwa; Naoto Horigome; Takeshi Hisa; Pardeep Mittal; Juan M Sarmiento; Shishir K Maithel; Jill Koshiol; Susan Tsai; Douglas Evans; Mert Erkan; Volkan Adsay Journal: Ann Surg Date: 2020-11-12 Impact factor: 13.787
Authors: Jean M Butte; Javiera Torres; Emanuela F Veras; Kenichi Matsuo; Mithat Gönen; Michael I D'Angelica; Enrique Waugh; Manuel Meneses; Yoshiyaki Inayama; Yuman Fong; Ronald P Dematteo; Hernan De La Fuente; Itaru Endo; David S Klimstra; William R Jarnagin Journal: Ann Surg Oncol Date: 2012-12-01 Impact factor: 5.344
Authors: H Kogure; T Tsujino; H Yagioka; T Sasaki; Y Nakai; K Hirano; N Sasahira; H Isayama; M Tada; T Kawabe; M Omata Journal: Surg Endosc Date: 2008-03 Impact factor: 4.584
Authors: Hae Kyung Lee; Seong Jin Park; Bum Ha Yi; A Leum Lee; Jong Ho Moon; Yun Woo Chang Journal: Korean J Radiol Date: 2009 Jan-Feb Impact factor: 3.500