Unión biliopancreática anómala: Una enfermedad no exclusiva de pacientes orientales

Cano, Jesús García; Godoy, Moacir F.; Ariño, J Morillas; García, Jose Ignacio Pérez

doi:10.4321/s0212-71992007000800006

Cited by 3 publications

(3 citation statements)

References 3 publications

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“…CC disease is associated with various complications including obstructive jaundice, symptomatic choledocholithiasis, pancreatitis, cholangitis, spontaneous cyst rupture, secondary biliary cirrhosis, and cholangiocarcinoma[1]. Of particular concern is the increased risk of malignancy[6,18,34,35], which varies from 2.5% to 17.5%, with some reports as high as 21%[13,36-39]. Malignant risk in Western cohorts is likely overstated; the risk of malignancy may be higher in Eastern cohorts compared to Western cohorts, particularly in adults (Table 2).…”

Section: Malignant Riskmentioning

confidence: 99%

“…Of note, gallbladder carcinoma is found in 5% of CC disease patients with APBJ[45], usually in patients in their sixth or seventh decade of life, when adult cohorts are investigated[4]. Thus, it is perceived that the likelihood of the development of both bile duct cancer and gallbladder cancer increases in patients with CC and APBJ, whereas there is a significant predilection for gallbladder cancer in APBJ patients without CC[18,20,46-48].…”

Section: Malignant Riskmentioning

confidence: 99%

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Choledochal cysts: Similarities and differences between Asian and Western countries

Baison¹,

Bonds²,

Helton³

et al. 2019

WJG

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Choledochal cysts (CCs) are rare bile duct dilatations, intra-and/or extrahepatic, and have higher prevalence in the Asian population compared to Western populations. Most of the current literature on CC disease originates from Asia where these entities are most prevalent. They are thought to arise from an anomalous pancreaticobiliary junction, which are congenital anomalies between pancreatic and bile ducts. Some similarities in presentation between Eastern and Western patients exist such as female predominance, however, contemporary studies suggest that Asian patients may be more symptomatic on presentation. Even though CC disease presents with an increased malignant risk reported to be more than 10% after the second decade of life in Asian patients, this risk may be overstated in Western populations. Despite this difference in cancer risk, management guidelines for all patients with CC are based predominantly on observations reported from Asia where it is recommended that all CCs should be excised out of concern for the presence or development of biliary tract cancer.

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Section: Malignant Riskmentioning

confidence: 99%

Section: Malignant Riskmentioning

confidence: 99%

Choledochal cysts: Similarities and differences between Asian and Western countries

Baison¹,

Bonds²,

Helton³

et al. 2019

WJG

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“…However, data on the incidence and role in biliary carcinogen-esis of PBMs that are unaccompanied by choledochal cysts (“nondilated” type) are highly limited in the Western hemisphere. It has been increasingly appreciated that the frequency of PBM in the US population may in fact be similar to that in Japan, 17–21 about 1% of the population.…”

mentioning

confidence: 99%

Pancreatobiliary Maljunction-associated Gallbladder Cancer Is as Common in the West, Shows Distinct Clinicopathologic Characteristics and Offers an Invaluable Model for Anatomy-induced Reflux-associated Physio-chemical Carcinogenesis

et al. 2020

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Objective:To determine the associations of pancreatobiliary maljunction (PBM) in the West.Background:PBM (anomalous union of common bile duct and pancreatic duct) is mostly regarded as an Asian-only disorder, with 200X risk of gallbladder cancer (GBc), attributed to reflux of pancreatic enzymes. Methods: Radiologic images of 840 patients in the US who underwent pancreatobiliary resections were reviewed for PBM and contrasted with 171 GBC cases from Japan.Results:Eight % of the US GBCs (24/300) had PBM (similar to Japan; 15/ 171, 8.8%), in addition to 1/42 bile duct carcinomas and 5/33 choledochal cysts. None of the 30 PBM cases from the US had been diagnosed as PBM in the original work-up. PBM was not found in other pancreatobiliary disorders. Clinicopathologic features of the 39 PBM-associated GBCs (US:24, Japan:15) were similar; however, comparison with non-PBM GBCs revealed that they occurred predominantly in females (F/M = 3); at younger (<50-year-old) age (21% vs 6.5% in non-PBM GBCs; P = 0.01); were uncommonly associated with gallstones (14% vs 58%; P < 0.001); had higher rate of tumor-infiltrating lymphocytes (69% vs 44%; P = 0.04); arose more often through adenoma-carcinoma sequence (31% vs 12%; P = 0.02); and had a higher proportion of nonconventional carcinomas (21% vs 7%; P = 0.03). Conclusions: PBM accounts for 8% of GBCs also in the West but is typically undiagnosed. PBM-GBCs tend to manifest in younger age and often through adenoma-carcinoma sequence, leading to unusual carcinoma types. If PBM is encountered, cholecystectomy and surveillance of bile ducts is warranted. PBM-associated GBCs offer an invaluable model for variant anatomy-induced chemical (reflux-related) carcinogenesis.

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Characteristics, Diagnosis and Treatment of Choledochal Cysts

Tüysüz

2023

Biliary Tract - Review and Recent Progress

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Choledochal cysts are congenital dilatations of the intra- and extrahepatic biliary tract that cause various pancreatic and hepatobiliary disorders. Pancreaticobiliary maljunction (PBM) results in choledochal cysts. PBM is a congenital pancreatic and bile duct juncture anomaly. It is widely accepted that the clinical presence of PBM is an etiological factor in the pathogenesis of biliary carcinogenesis in patients with choledochal cysts. For definitive diagnosis, ultrasonography sometimes shows the relationship with the biliary tract. If USG findings cannot rule out other causes, ideally MRI should be performed together with MRCP. CT may be the initial test for undiagnosed common bile duct malformations. In rare cases where conventional imaging results are uncertain, nuclear hepatobiliary iminodiacetic acid (HIDA) scanning enables the evaluation of radiological trace of involvement and accumulation in cystic structures associated with the biliary system. Todani added five anomalies and organized the most commonly used classification system. There are five subtypes. A type I cyst, A choledochal diverticulum (Todani type II), Choledochoceles (Todani type III), type IV cyst, Caroli disease (Todani type V). Surgical treatment should be based on the extent of biliary involvement based on the widely used Todani classification and anatomical findings and the presence or absence of PBM. The standard treatment in most CCs is the resection of the bile duct up to the lobar bifurcation. Residual postoperative intrapancreatic choledochal cyst may also lead to secondary carcinogenesis and associated morbidity. The localization of the pancreatic cyst is inside the head of the pancreas, close to the neck and to the left of the bile duct. Surgical treatment options include laparoscopic treatment. Its main advantages include excellent visualization and low blood loss.

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Unión biliopancreática anómala: Una enfermedad no exclusiva de pacientes orientales

Cited by 3 publications

References 3 publications

Choledochal cysts: Similarities and differences between Asian and Western countries

Choledochal cysts: Similarities and differences between Asian and Western countries

Pancreatobiliary Maljunction-associated Gallbladder Cancer Is as Common in the West, Shows Distinct Clinicopathologic Characteristics and Offers an Invaluable Model for Anatomy-induced Reflux-associated Physio-chemical Carcinogenesis

Characteristics, Diagnosis and Treatment of Choledochal Cysts

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