Several factors, gall stones, calcified gallbladders, carcinogens(methylcholanthrene pellets, α-aminoazotoluene, nitrosamides), benign neoplasms of gallbladder(polyp, adenoma), anomlous junction of pancreaticobiliary ductal system(AJPBDS)
associated
with the gallbladder cancer.
Among these factors, AJPBDS) was studied in the gallbladder cancers that we had experienced. The AJPBDS has been defined as the junction between the choledochus and pancreatic duct outside of the duodenal wall and beyond the influence of the
sphincter
of Boyden.
The mode of junction of the pancreaticobiliary duct was divided into two types. type I (pancreaticocholedochal type) and type II(choledochopancreatic type). The AJPBDS was thought to be related with gallbladder carcinoma via reflux and stasis of
pancreatic juice in the gallbladder. We found the 9 cases of AJPBDS among 34 cases that the ERCP was performed in the 99 cases of gallbladder carcinomas during past 12 years and the results were as follows:
1) The average age was 56.8 years.
2) The male to female ratio was 1:4.5 but 1:2.43 in the gallbladder cancer without AJPBDS.
3) Among 9 cases of AJPDDS, 4 cases were type I and 5 cases were type II.
4) The average length of the common channel was 21.3mm in the type I, 16.4mm in the type II.
5) The macroscopic views of the gallbladder cancer with AJPBDS were classified into 3 types: diffuse type(6 cases, 66.65), papillary type(2 cases, 22.2%) and nodular type(1 case, 11.1%)
6) The microscopic classification of the gallbladder cancer with AJPBDS were poorly differentiated(4 cases), papillary well differentiated(2 cases), well differentiated (1 case), tubular well differentiated (1 case) and cytologic
adenocarcinoma(1
case)
7) The locations of the tumor were in the fundus(5 cases 5.5%), body(2 cases, 22.2%) and neck(2 cases, 22.2%).
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