Pancreaticobiliary maljunction and carcinogenesis to biliary and pancreatic malignancy

Funabiki, Takuzo; Matsubara, Toshiki; Miyakawa, Shuichi; Ishihara, Shoichiro

doi:10.1007/s00423-008-0336-0

Cited by 160 publications

(154 citation statements)

References 55 publications

Supporting

Mentioning

149

Contrasting

Unclassified

Order By: Relevance

“…Due to the lack of sphincter action at the union of the pancreatic and bile ducts, bile and pancreatic juice are mixed, resulting in the activation of cell toxic factors. These factors are considered to induce chronic cholangitis, which may result in carcinogenesis [18,19]. PBM is divided into two groups by the existence of bile duct dilatation (PBM with or without bile duct dilatation) [17].…”

Section: Prophylactic Treatmentmentioning

confidence: 99%

Clinical practice guidelines for the management of biliary tract cancers 2015: the 2^nd English edition

Miyazaki

Yoshitomi

Miyakawa³

et al. 2015

J Hepato Biliary Pancreat

Self Cite

237

165

View full text Add to dashboard Cite

Background The Japanese Society of Hepato-Biliary-Pancreatic Surgery launched the clinical practice guidelines for the management of biliary tract and ampullary carcinomas in 2008. Novel treatment modalities and handling of clinical issues have been proposed after the publication. New approaches for editing clinical guidelines, such as the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system, also have been introduced for better and clearer grading of recommendations. Methods Clinical questions (CQs) were proposed in seven topics. Recommendation, grade of recommendation and statement for each CQ were discussed and finalized by evidencebased approach. Recommendation was graded to grade 1 (strong) and 2 (weak) according to the concept of GRADE system. Results The 29 CQs covered seven topics: (1) prophylactic treatment, (2) diagnosis, (3) biliary drainage, (4) surgical treatment, (5) chemotherapy, (6) radiation therapy, and (7) pathology. In 27 CQs, 19 recommendations were rated strong and 11 recommendations weak. Each CQ included the statement of how the recommendation was graded. Conclusions This guideline provides recommendation for important clinical aspects based on evidence. Future collaboration with cancer registry will be a key for assessment of the guidelines and establishment of new evidence. Free full-text articles and a mobile application of this guideline are available via

show abstract

Section: Prophylactic Treatmentmentioning

confidence: 99%

Clinical practice guidelines for the management of biliary tract cancers 2015: the 2^nd English edition

Miyazaki

Yoshitomi

Miyakawa³

et al. 2015

J Hepato Biliary Pancreat

Self Cite

237

165

View full text Add to dashboard Cite

show abstract

“…Biliary cancers are frequently observed in adult patients with PBM [23][24][25]. According to a nationwide survey in Fig.…”

Section: Incidence and Characteristicsmentioning

confidence: 99%

“…Prophylactic cholecystectomy is performed in many institutes, as most biliary cancers that develop in PBM patients without biliary dilatation are gallbladder cancers [38,39]. However, some surgeons propose excision of the extrahepatic bile duct together with the gallbladder for PBM patients without biliary dilatation [23], because the frequency of bile duct cancer in PBM patients without biliary dilatation is higher compared to that in the general population [2], and K-ras and/or p53 gene mutations are also reportedly seen in the bile duct of PBM patients without biliary dilatation [23,40].…”

Section: Treatment Of Pbmmentioning

confidence: 99%

Pancreaticobiliary maljunction and biliary cancer

et al. 2014

View full text Add to dashboard Cite

Pancreaticobiliary maljunction (PBM) is a congenital malformation in which the pancreatic and bile ducts join anatomically outside the duodenal wall. Japanese clinical practice guidelines on how to deal with PBM were made in 2012, representing a world first. According to the 2013 revision to the diagnostic criteria for PBM, in addition to direct cholangiography, diagnosis can be made by magnetic resonance cholangiopancreatography (MRCP), 3-dimensional drip infusion cholangiography computed tomography, endoscopic ultrasonography (US), or multiplanar reconstruction images by multidetector row computed tomography. In PBM, the common channel is so long that sphincter action does not affect the pancreaticobiliary junction, and pancreatic juice frequently refluxes into the biliary tract. Persistence of refluxed pancreatic juice injures epithelium of the biliary tract and promotes cancer development, resulting in higher rates of carcinogenesis in the biliary tract. In a nationwide survey, biliary cancer was detected in 21.6 % of adult patients with congenital biliary dilatation (bile duct cancer, 32.1 % vs. gallbladder cancer, 62.3 %) and in 42.4 % of PBM patients without biliary dilatation (bile duct cancer, 7.3 % vs. gallbladder cancer, 88.1 %). Pathophysiological conditions due to pancreatobiliary reflux occur in patients with high confluence of pancreaticobiliary ducts, a common channel C6 mm long, and occlusion of communication during contraction of the sphincter. Once the diagnosis of PBM is established, immediate prophylactic surgery is recommended. However, the surgical strategy for PBM without biliary dilatation remains controversial. To detect PBM without biliary dilatation early, MRCP is recommended for patients showing gallbladder wall thickening on screening US under suspicion of PBM.

show abstract

“…Notably, the risk of BTC increases ~400-fold in patients with PSC, in comparison with the general population (13). Additionally, in patients with pancreaticobiliary maljunction (PBM), the incidence of GBC and BTC are ~14.8 and 4.9%, respectively (14). Patients with PBM suffer from frequent refluxes of pancreatic juice into the biliary tract, which causes damage to the epithelium of the biliary tract (14).…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, in patients with pancreaticobiliary maljunction (PBM), the incidence of GBC and BTC are ~14.8 and 4.9%, respectively (14). Patients with PBM suffer from frequent refluxes of pancreatic juice into the biliary tract, which causes damage to the epithelium of the biliary tract (14). Chronic inflammation exposes epithelial cells to cytokines and interferons, which causes genotoxic stress through the production of reactive oxygen species (14).…”

Section: Introductionmentioning

confidence: 99%

Genetic alterations in Japanese extrahepatic biliary tract cancer

et al. 2017

View full text Add to dashboard Cite

show abstract

Pancreaticobiliary maljunction and carcinogenesis to biliary and pancreatic malignancy

Cited by 160 publications

References 55 publications

Clinical practice guidelines for the management of biliary tract cancers 2015: the 2^nd English edition

Clinical practice guidelines for the management of biliary tract cancers 2015: the 2^nd English edition

Pancreaticobiliary maljunction and biliary cancer

Genetic alterations in Japanese extrahepatic biliary tract cancer

Contact Info

Product

Resources

About

Pancreaticobiliary maljunction and carcinogenesis to biliary and pancreatic malignancy

Cited by 160 publications

References 55 publications

Clinical practice guidelines for the management of biliary tract cancers 2015: the 2nd English edition

Clinical practice guidelines for the management of biliary tract cancers 2015: the 2nd English edition

Pancreaticobiliary maljunction and biliary cancer

Genetic alterations in Japanese extrahepatic biliary tract cancer

Contact Info

Product

Resources

About

Clinical practice guidelines for the management of biliary tract cancers 2015: the 2^nd English edition

Clinical practice guidelines for the management of biliary tract cancers 2015: the 2^nd English edition