High risk of bile duct carcinogenesis after primary resection of a congenital biliary dilatation

Tsuchida, Akihiko; Kasuya, Kazuhiko; Endo, Mitsufumi; Saitô, Hitoshi; Inoue, Keiichiro; Nagae, Itsuro; Aoki, Tasuya; Koyanagi, Yasuhisa

doi:10.3892/or.10.5.1183

Cited by 19 publications

(13 citation statements)

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“…Metaplasia and dysplasia are also observed in the PBM biliary mucosa, and even in child cases [33]. While hyperplasia, metaplasia and dysplasia are scarcely observed in the noncancerous portion of gallbladder cancer and bile duct cancer not associated with PBM.…”

Section: Mucosal Structurementioning

confidence: 97%

“…Ohuchida et al [24] indicated that PBM not associated with biliary dilatation is more risky with respect to carcinogenesis. Cases of pancreatic cancer after operation for congenital biliary dilatation were often reported [33], which suggests a specific relationship between the pancreatic cancer and PBM [1,33].…”

Section: Pancreatic Carcinomamentioning

confidence: 99%

“…Carcinogenesis by promoters in the mixed contents might be protected by biliary diversion, while in remnant bile duct mucosa preceding progression process to cancer might advance with the passage of time. In fact, frequency of the bile duct carcinoma after excision is very high [33,71]. So, extended or total excision of the biliary tract is necessary.…”

Section: Treatmentmentioning

confidence: 99%

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Pancreaticobiliary maljunction and carcinogenesis to biliary and pancreatic malignancy

Funabiki

Matsubara²,

Miyakawa

et al. 2008

Langenbecks Arch Surg

160

146

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Section: Mucosal Structurementioning

confidence: 97%

Section: Pancreatic Carcinomamentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

See 1 more Smart Citation

Pancreaticobiliary maljunction and carcinogenesis to biliary and pancreatic malignancy

Funabiki

Matsubara²,

Miyakawa

et al. 2008

Langenbecks Arch Surg

160

146

View full text Add to dashboard Cite

show abstract

“…There is increasing evidence of patients who develop cancer in the intrahepatic bile duct, cancer in the hepatic duct at the site of anastomosis, or cancer in the residual intrapancreatic bile duct following biliary diversion [149]. However, no large-scale study exists on the development of biliary tract cancers after such biliary diversion procedures or following biliopancreatic undiversion, either for congenital biliary dilatation or for PBM without biliary dilatation.…”

Section: Commentsmentioning

confidence: 98%

Japanese clinical practice guidelines for pancreaticobiliary maljunction

et al. 2012

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There have been no clinical guidelines for the management of pancreaticobiliary maljunction (PBM). The Japanese Study Group on Pancreaticobiliary Maljunction (JSPBM) has proposed to establish clinical practice guidelines on how to deal with PBM, with the support of the Japan Biliary Association (JBA). Because the body of evidence-based literature is relatively small, we decided to create guidelines based on the consensus of experts, using the medical literature for reference. A total of 46 clinical questions (CQs) were considered by the members of the editorial committee responsible for the guidelines. The CQs covered distinct aspects of PBM: (1) Concepts and Pathophysiology (10 CQs); (2) Diagnosis (10 CQs); (3) Pancreatobiliary complications (9 CQs); and (4) Treatments and prognosis (17 CQs). Statements and comments for each CQ were prepared by the guidelines committee members and collaborating partners. The CQs were completed after review by members of the editorial committee, meetings of this committee, public comments on the homepages of the JSPBM and the JBA, public hearings, and assessment and approval by the guidelines evaluation board. PBM includes cases where the bile duct is dilated (PBM with biliary dilatation) and those in which it is not (PBM without biliary dilatation). In these guidelines, PBM with biliary dilatation is defined as being identical to congenital biliary dilatation of Todani type I (except for type Ib) and type IV-A, both of which are accompanied by PBM in almost all cases. These guidelines are created to provide assistance in the clinical practice of PBM management; their contents focus on clinical utility, and they include general information on PBM to make this disease more widely recognized.

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“…Bile stasis is caused by anastomotic stricture of hepaticoenterostomy or congenital stenosis and dilatation of intrahepatic bile ducts [2,9,10]. Carcinogenesis in the residual bile ducts is also increasingly reported [11][12][13][14]. Kobayashi et al encountered three such patients after 47 choledochal cyst excisions, and concluded by the person-year statistical analysis that the incidence of bile duct carcinoma after cyst excision is still 121.5 times higher than in the general population [12].…”

mentioning

confidence: 96%

Proteomic Analysis of Protein Plugs: Causative Agent of Symptoms in Patients with Choledochal Cyst

et al. 2007

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Symptoms of choledochal cysts are caused by protein plugs. We performed proteomic analysis of protein plugs to elucidate formation mechanism. Protein plugs were obtained from three pediatric patients with choledochal cyst. Proteins were separated using sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Gel bands common to the samples were excised for mass spectrometry. Mass spectra were compared with the NCBI database for protein identification. Gel bands of protein plug samples were predominant at 14 kilodaltons (kDa), followed by 29 kDa. Four other thin bands were common to the plug samples. Four bands (including 14 and 29 kDa) were identified as lithostathine, and one band as serum albumin. Plugs consisted mostly of lithostathine, a protein secreted by pancreatic acinar cells into pancreatic juice. The mechanism involves trypsinogen and lithostathine regurgitating into the cyst through an aberrant union of pancreaticobiliary ducts. Activated trypsin cleaves soluble lithostathine into insoluble forms that aggregate to form plugs.

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High risk of bile duct carcinogenesis after primary resection of a congenital biliary dilatation

Cited by 19 publications

References 0 publications

Pancreaticobiliary maljunction and carcinogenesis to biliary and pancreatic malignancy

Pancreaticobiliary maljunction and carcinogenesis to biliary and pancreatic malignancy

Japanese clinical practice guidelines for pancreaticobiliary maljunction

Proteomic Analysis of Protein Plugs: Causative Agent of Symptoms in Patients with Choledochal Cyst

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