CLINICAL-EXPERIENCE OF BILIARY-TRACT CARCINOMA ASSOCIATED WITH ANOMALOUS UNION OF THE PANCREATICOBILIARY DUCTAL SYSTEM

被引：25

作者：

OHTA, T

NAGAKAWA, T

UENO, K

MAEDA, K

UEDA, N

KAYAHARA, M

AKIYAMA, T

KANNO, M

KONISHI, I

IZUMI, R

KONISHI, K

MIYAZAKI, I

机构：

[1] The Second Department of Surgery, School of Medicine, Kanazawa University, Kanazawa, 920

来源：

JAPANESE JOURNAL OF SURGERY | 1990年 / 20卷 / 01期

关键词：

anomalous union of the pancreaticobiliary ductal system; atypical epithelial hyperplasia of the bile duct; biliary tract carcinoma;

D O I：

10.1007/BF02470711

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Between 1978 and 1988, 15 patients with gallbladder cancer and 2 patients with bile duct cancer were seen among 49 patients with anomalous union of the pancreaticobiliary ductal system. Radiographic findings revealed two types of this anomalous condition: one in which the pancreatic duct entered the common bile duct(type 1) and one in which the common bile duct entered the pancreatic duct (type 2). In gallbladder cancer, the common bile duct presented no dilatation, or in some patients, mild dilatation, and type-1 anomalous union was frequently found among these patients. In contrast, the two patients with bile duct cancer had cystic dilatation of the common bile duct and type-2 anomalous union. The bile amylase level, which was determined in seven patients, was extremely high in all the patients. Histopathologically, the tumors in most patients showed papillary to papillo-tubular proliferation in the mucosal layer while atypical epithelial hyperplasia was noted in the vicinity of the tumor area. These findings suggest that this congenital anomaly in both ducts results in a loss of the normal sphincteric mechanism of the doudenal papilla, and that chronic relapsing cholecystitis or cholangitis, caused by the reflux of pancreatic juice into the biliary tract, can induced progressive changes to atypical epithelial hyperplasia which may develop into carcinoma. © 1990 The Japan Surgical Society.

引用

页码：36 / 43

页数：8

共 23 条

[11]

Matsuzaki Y., Tanaka N., Ohsuga T., Cholelithiasis and carcinoma of the gallbladder, Tan to Sui, 8, pp. 1525-1529, (1987)

[12]

Funabiki T., Sugiue K., Ochiai M., Amano H., Fujita S., Futawatari H., Yamaguchi H., Matsubara T., Kamei K., Fukui H., Hasegawa S., Studies on the bile acid fractions in the bile obtained from the patients with anomalous arrangement of the pancreaticobiliary ductal system, Biliary Tract, 1, pp. 77-83, (1987)

[13]

Kozuka S., Tsubone M., Yasui A., Hachisuka K., Relation of adenoma to carcinoma in the gallbladder, Cancer, 50, pp. 2226-2234, (1982)

[14]

Ohakawa H., Sawaguchi S., Yamazaki Y., Sakaniwa M., Ishikawa A., Research on animal models of the anomalous pancreatico-biliary ductal union, Nippon Shonigeka Gakkai Zasshi, 18, pp. 185-191, (1982)

[15]

Ogura Y., Exp1/4erimental studies on reflux of pancreatic juice into the biliary tract with special reference to the effects in the hepato-biliary system, Nippon Geka Gakkai Zasshi, 84, pp. 141-150, (1983)

[16]

Ming S.C., Goldman H., Freiman D.G., Intestinal metaplasia and histogenesis of carcinoma in human stomach, Cancer, 20, pp. 1418-1429, (1967)

[17]

Lauren P., The two histological main types of gastric carcinoma, Acta Pathol Microbiol Scand, 65, pp. 31-49, (1965)

[18]

Jarvi O., Lauren P., Intestinal metaplasia in the mucosa of the gallbladder and common bile duct, Ann Med Exp Fenn, 45, pp. 213-223, (1967)

[19]

Hirai S., Clinicopathological study on metaplasia in resected gallbladder: As a background of histogenesis of gallbladder cancer, The Japanese Journal of Gastroenterological Surgery, 13, pp. 35-44, (1980)

[20]

Kozuka S., Kurashina M., Tsubone M., Hachisuka K., Yasui A., Significance of intestinal metaplasia for the evolution of cancer in the biliary tract, Cancer, 54, pp. 2277-2285, (1984)

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