Top

World Journal of Surgery

Published in:

01-05-2016 | Original Scientific Report

Clinicopathologic Differences in Patients with Gallbladder Cancer According to the Presence of Anomalous Biliopancreatic Junction

Authors: Jihoon Chang, Jin-Young Jang, Mee Joo Kang, Woohyun Jung, Yong Chan Shin, Sun-Whe Kim

Published in: World Journal of Surgery | Issue 5/2016

Abstract

Background

Anomalous biliopancreatic junction (ABPJ) is a risk factor for gallbladder cancer (GBC). This study investigated the significance of ABPJ in patients with GBC.

Methods

Of the 453 patients with GBC underwent surgery at Seoul National University Hospital between 2000 and 2014, the 401 patients who can be assessed for the presence of ABPJ with radiologic image were analyzed.

Results

The 401 patients with GBC included 183 (45.6 %) males and 218 (54.4 %) females. ABPJ was identified in 69 (17.2 %) patients, 22 (31.9 %) males and 47 (68.1 %) females. Choledochal cyst (CC) was identified in 18 (4.5 %) patients, all of whom had ABPJ. Curative surgery was accomplished in 68.1 %. A comparison of patients with and without ABPJ showed that mean age (59.9 vs. 65.1 years, p < 0.001) and association with gallbladder stone (8.7 vs. 24.7 %, p = 0.002) were significantly lower in the ABPJ group, while the proportion of female (68.1 vs. 51.5 %, p = 0.012), bile duct resection rate (47.8 vs. 18.4 %, p < 0.001), and curative resection rate (81.1 vs. 65.7 %, p = 0.003) were significantly higher in the ABPJ group. Overall 5-year survival rates were similar in the ABPJ and non-ABPJ groups (74.4 vs. 69.0 %, p = 0.533). In patients with ABPJ, the presence of CC did not have a significant effect on survival (p = 0.099).

Conclusions

ABPJ was found in 17.2 % of patients with GBC. ABPJ is associated with younger age, female gender, absence of gallbladder stones, higher BDR rate, and higher curative resection rate. However, neither ABPJ nor CC was prognostic of survival in curatively treated patients with GBC.

Ferlay J, Soerjomataram I, Dikshit R et al (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136:E359–E386CrossRefPubMed

Cubertafond P, Gainant A, Cucchiaro G (1994) Surgical treatment of 724 carcinomas of the gallbladder. Results of the French Surgical Association Survey. Ann Surg 219:275–280CrossRefPubMedPubMedCentral

Horner M, Ries L, Krapcho M et al (2009) SEER cancer statistics review, 1975–2006. National Cancer Institute, Bethesda

Randi G, Franceschi S, La Vecchia C (2006) Gallbladder cancer worldwide: geographical distribution and risk factors. Int J Cancer 118:1591–1602CrossRefPubMed

Kamisawa T, Ando H, Suyama M et al (2012) Japanese clinical practice guidelines for pancreaticobiliary maljunction. J Gastroenterol 47:731–759CrossRefPubMed

Wiseman K, Buczkowski AK, Chung SW et al (2005) Epidemiology, presentation, diagnosis, and outcomes of choledochal cysts in adults in an urban environment. Am J Surg 189:527–531CrossRefPubMed

Soares KC, Arnaoutakis DJ, Kamel I et al (2014) Choledochal cysts: presentation, clinical differentiation, and management. J Am Coll Surg 219:1167–1180CrossRefPubMedPubMedCentral

Lee SE, Jang JY, Lee YJ et al (2011) Choledochal cyst and associated malignant tumors in adults: a multicenter survey in South Korea. Arch Surg 146:1178–1184CrossRefPubMed

Hu B, Gong B, Zhou DY (2003) Association of anomalous pancreaticobiliary ductal junction with gallbladder carcinoma in Chinese patients: an ERCP study. Gastrointest Endosc 57:541–545CrossRefPubMed

10.

Morine Y, Shimada M, Ishibashi H (2014) Nation wide survey of pancreaticobiliary maljunction. Jpn J Gastroenterol 111:699–705

11.

Nagi B, Kochhar R, Bhasin D et al (2003) Endoscopic retrograde cholangiopancreatography in the evaluation of anomalous junction of the pancreaticobiliary duct and related disorders. Abdom Imaging 28:847–852CrossRefPubMed

12.

Funabiki T, Matsubara T, Miyakawa S et al (2009) Pancreaticobiliary maljunction and carcinogenesis to biliary and pancreatic malignancy. Langenbecks Arch Surg 394:159–169CrossRefPubMed

13.

Kamisawa T, Kuruma S, Tabata T et al (2015) Pancreaticobiliary maljunction and biliary cancer. J Gastroenterol 50:273–279CrossRefPubMed

14.

Todani T, Watanabe Y, Narusue M et al (1977) Congenital bile duct cysts: classification, operative procedures, and review of thirty-seven cases including cancer arising from choledochal cyst. Am J Surg 134:263–269CrossRefPubMed

15.

Siegel R, Ma J, Zou Z et al (2014) Cancer statistics, 2014. CA Cancer J Clin 64:9–29CrossRefPubMed

16.

Kamisawa T, Ando H, Hamada Y et al (2014) Diagnostic criteria for pancreaticobiliary maljunction 2013. J Hepatobiliary Pancreat Sci 21:159–161CrossRefPubMed

17.

Morine Y, Shimada M, Takamatsu H et al (2013) Clinical features of pancreaticobiliary maljunction: update analysis of 2nd Japan-nationwide survey. J Hepatobiliary Pancreat Sci 20:472–480CrossRefPubMed

18.

Kim HJ, Kim MH, Lee SK et al (2002) Normal structure, variations, and anomalies of the pancreaticobiliary ducts of Koreans: a nationwide cooperative prospective study. Gastrointest Endosc 55:889–896CrossRefPubMed

19.

Kimura K, Ohto M, Saisho H et al (1985) Association of gallbladder carcinoma and anomalous pancreaticobiliary ductal union. Gastroenterology 89:1258–1265PubMed

20.

Khan ZR, Neugut AI, Ahsan H et al (1999) Risk factors for biliary tract cancers. Am J Gastroenterol 94(149–15):2

21.

Motosugi U, Ichikawa T, Araki T et al (2007) Secretin-stimulating MRCP in patients with pancreatobiliary maljunction and occult pancreatobiliary reflux: direct demonstration of pancreatobiliary reflux. Eur Radiol 17:2262–2267CrossRefPubMed

22.

Sakamoto H, Mutoh H, Ido K et al (2009) Intestinal metaplasia in gallbladder correlates with high amylase levels in bile in patients with a morphologically normal pancreaticobiliary duct. Hum Pathol 40:1762–1767CrossRefPubMed

23.

Matsubara T, Sakurai Y, Zhi LZ et al (2002) K-ras and p53 gene mutations in noncancerous biliary lesions of patients with pancreaticobiliary maljunction. J Hepatobiliary Pancreat Surg 9:312–321CrossRefPubMed

24.

Ohuchida J, Chijiiwa K, Hiyoshi M et al (2006) Long-term results of treatment for pancreaticobiliary maljunction without bile duct dilatation. Arch Surg 141:1066–1070CrossRefPubMed

25.

Kamisawa T, Tu Y, Kuwata G et al (2006) Biliary carcinoma risk in patients with pancreaticobiliary maljunction and the degree of extrahepatic bile duct dilatation. Hepatogastroenterology 53:816–818PubMed

26.

Kusano T, Takao T, Tachibana K et al (2005) Whether or not prophylactic excision of the extrahepatic bile duct is appropriate for patients with pancreaticobiliary maljunction without bile duct dilatation. Hepatogastroenterology 52:1649–1653PubMed

27.

Hanada K, Tsuchida A, Kajiyama G (1999) Cellular kinetics and gene mutations in gallbladder mucosa with an anomalous junction of pancreaticobiliary duct. J Hepatobiliary Pancreat Surg 6:223–228CrossRefPubMed

28.

Tokiwa K, Ono S, Iwai N (1999) Mucosal cell proliferation activity of the gallbladder in children with anomalous arrangement of the pancreaticobiliary duct. J Hepatobiliary Pancreat Surg 6:213–217CrossRefPubMed

29.

Tan Y, Ma SY, Wang FQ et al (2011) Proteomic-based analysis for identification of potential serum biomarkers in gallbladder cancer. Oncol Rep 26:853–859PubMed

Title: Clinicopathologic Differences in Patients with Gallbladder Cancer According to the Presence of Anomalous Biliopancreatic Junction
Authors: Jihoon Chang
Jin-Young Jang
Mee Joo Kang
Woohyun Jung
Yong Chan Shin
Sun-Whe Kim
Publication date: 01-05-2016
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 5/2016
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-015-3359-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Clinicopathologic Differences in Patients with Gallbladder Cancer According to the Presence of Anomalous Biliopancreatic Junction

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 5/2016

Survival After Endovascular Abdominal Aortic Aneurysm Repair in a Population with a Low Incidence of Coronary Artery Disease

Where Oncologic and Surgical Complication Scoring Systems Collide: Time for a New Consensus for CRS/HIPEC

Patterns of Use and Short-Term Outcomes of Minimally Invasive Surgery for Malignant Pheochromocytoma: A Population-Level Study: Reply

Safety of Laparoscopic Pelvic Exenteration with Urinary Diversion for Colorectal Malignancies

Factors Affecting Hospital Mortality in Patients with Esophagogastric Anastomotic Leak: A Retrospective Study

Clinical Significance of Splenic Hilar Dissection with Splenectomy in Advanced Proximal Gastric Cancer: An Analysis at a Single Institution in Japan