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KMID : 0870420030070020220
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Korean Journal of Hepato-Biliary-Pancreatic Surgery
2003 Volume.7 No. 2 p.220 ~ p.227
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A Study for Mechanism of Biliary Ductal Injury in Patients with Anomalous Pancreaticobiliary Ductal Union (A Study for Mechanism of Biliary Injury in APBDU)
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Jeong In-Ho
Jung Yong-Sik
Kim Ji-Hun
Choi Su-Yoon
Kim Jung-Woon
Kim Wook-Whan
Hong Jeong
Wang Hee-Jung
Yoo Byung-Moo
Kim Jin-Hong
Han Jae-Ho
Kim Young-Bae
Kim Jae-Keun
Kim Myung-Wook
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Abstract
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Purpose: It has been known that clinical features of anomalous pancreaticobiliary ductal union (APBDU) are thought to result from cholestasis and regurgitation of pancreatic juice. The purpose of our study is to clarify the relationship of clinicopathological factors and to get information on mechanism of biliary ductal injury in APBDU.
Methods: A total of 23 patients who underwent operation for APBDU from March 1995 to March 2003 were examined. The results of patients were analyzed for their relevance to the clinicopathological factors such as age, sex, age at onset, size of cyst, grade of inflammation, type of APBDU, level of pancreatic enzymes sampled from biliary ductal system, and Ki67 labeling index.
Results: Level of amylase in biliary ductal system was decreased with age, especially after 20 years. The grade of hyperplasia in gallbladder was increased with level of amylase in gallbladder. The grade of inflammation in gallbladder was increased with age, but inflammation of gallbladder decreased with the level of amylase in gallbladder, and the size of cyst was increased with grade of inflammation and age.
Conclusion: Level of amylase in the bile of biliary ductal system was decreased with age, especially after 20 years, which suggests that reflux of pancreatic amylase is closely related with onset of symptom in adult with APBDU. As far as mechanism of biliary ductal injury in APBDU is concerned, inflammation of biliary ductal system is increased with age and size of cyst. And hyperplasia of gallbladder is increased with the degree of regurgitation of pancreatic juice.
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KEYWORD
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Choledochal cyst, Anomalous pancreaticobiliary ductal union (APBDU), Amylase, Ki67 protein
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