Clinicopathologic Differences in Patients with Gallbladder Cancer According to the Presence of Anomalous Biliopancreatic Junction

Overview

Journal World J Surg

Publisher Wiley

Specialty General Surgery

Date 2015 Dec 4

PMID 26630938

Citations 4

Authors

Jihoon Chang

Jin-Young Jang

Mee Joo Kang

Woohyun Jung

Yong Chan Shin

Sun-Whe Kim

Affiliations

Soon will be listed here.

Abstract

Background: Anomalous biliopancreatic junction (ABPJ) is a risk factor for gallbladder cancer (GBC). This study investigated the significance of ABPJ in patients with GBC.

Methods: Of the 453 patients with GBC underwent surgery at Seoul National University Hospital between 2000 and 2014, the 401 patients who can be assessed for the presence of ABPJ with radiologic image were analyzed.

Results: The 401 patients with GBC included 183 (45.6 %) males and 218 (54.4 %) females. ABPJ was identified in 69 (17.2 %) patients, 22 (31.9 %) males and 47 (68.1 %) females. Choledochal cyst (CC) was identified in 18 (4.5 %) patients, all of whom had ABPJ. Curative surgery was accomplished in 68.1 %. A comparison of patients with and without ABPJ showed that mean age (59.9 vs. 65.1 years, p < 0.001) and association with gallbladder stone (8.7 vs. 24.7 %, p = 0.002) were significantly lower in the ABPJ group, while the proportion of female (68.1 vs. 51.5 %, p = 0.012), bile duct resection rate (47.8 vs. 18.4 %, p < 0.001), and curative resection rate (81.1 vs. 65.7 %, p = 0.003) were significantly higher in the ABPJ group. Overall 5-year survival rates were similar in the ABPJ and non-ABPJ groups (74.4 vs. 69.0 %, p = 0.533). In patients with ABPJ, the presence of CC did not have a significant effect on survival (p = 0.099).

Conclusions: ABPJ was found in 17.2 % of patients with GBC. ABPJ is associated with younger age, female gender, absence of gallbladder stones, higher BDR rate, and higher curative resection rate. However, neither ABPJ nor CC was prognostic of survival in curatively treated patients with GBC.

Citing Articles

Clinical characteristics of patients with malignancy and long-term outcomes of surgical treatment of patients with choledochal cyst.

Han W, Kim H, Sohn H, Lee M, Kang Y, Kim H Ann Surg Treat Res. 2021; 101(6):332-339.

PMID: 34934760 PMC: 8651987. DOI: 10.4174/astr.2021.101.6.332.

A narrative review of gallbladder adenomyomatosis: what we need to know.

Lee K, Hung E, Leung H, Lai P Ann Transl Med. 2021; 8(23):1600.

PMID: 33437799 PMC: 7791251. DOI: 10.21037/atm-20-4897.

T2 gallbladder cancer shows substantial survival variation between continents and this is not due to histopathologic criteria or pathologic sampling differences.

DeSimone M, Goodman M, Pehlivanoglu B, Memis B, Balci S, Roa J Virchows Arch. 2021; 478(5):875-884.

PMID: 33411027 DOI: 10.1007/s00428-020-02968-5.

Surgical Outcomes for Perihilar Cholangiocarcinoma with Vascular Invasion.

Higuchi R, Yazawa T, Uemura S, Izumo W, Ota T, Kiyohara K J Gastrointest Surg. 2018; 23(7):1443-1453.

PMID: 30203230 DOI: 10.1007/s11605-018-3948-x.

References

Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M . Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2014; 136(5):E359-86. DOI: 10.1002/ijc.29210. View

Kamisawa T, Ando H, Suyama M, Shimada M, Morine Y, Shimada H . Japanese clinical practice guidelines for pancreaticobiliary maljunction. J Gastroenterol. 2012; 47(7):731-59. DOI: 10.1007/s00535-012-0611-2. View

Matsubara T, Sakurai Y, Zhi L, Miura H, Ochiai M, Funabiki T . K-ras and p53 gene mutations in noncancerous biliary lesions of patients with pancreaticobiliary maljunction. J Hepatobiliary Pancreat Surg. 2002; 9(3):312-21. DOI: 10.1007/s005340200035. View

Nagi B, Kochhar R, Bhasin D, Singh K . Endoscopic retrograde cholangiopancreatography in the evaluation of anomalous junction of the pancreaticobiliary duct and related disorders. Abdom Imaging. 2004; 28(6):847-52. DOI: 10.1007/s00261-003-0031-0. View

Ohuchida J, Chijiiwa K, Hiyoshi M, Kobayashi K, Konomi H, Tanaka M . Long-term results of treatment for pancreaticobiliary maljunction without bile duct dilatation. Arch Surg. 2006; 141(11):1066-70. DOI: 10.1001/archsurg.141.11.1066. View

Lee S, Jang J, Lee Y, Choi D, Lee W, Cho B . Choledochal cyst and associated malignant tumors in adults: a multicenter survey in South Korea. Arch Surg. 2011; 146(10):1178-84. DOI: 10.1001/archsurg.2011.243. View

Morine Y, Shimada M, Ishibashi H . [Nation wide survey of pancreaticobiliary maljunction]. Nihon Shokakibyo Gakkai Zasshi. 2014; 111(4):699-705. View

Motosugi U, Ichikawa T, Araki T, Kitahara F, Sato T, Itakura J . Secretin-stimulating MRCP in patients with pancreatobiliary maljunction and occult pancreatobiliary reflux: direct demonstration of pancreatobiliary reflux. Eur Radiol. 2007; 17(9):2262-7. DOI: 10.1007/s00330-007-0640-z. View

Tan Y, Ma S, Wang F, Meng H, Mei C, Liu A . Proteomic-based analysis for identification of potential serum biomarkers in gallbladder cancer. Oncol Rep. 2011; 26(4):853-9. DOI: 10.3892/or.2011.1353. View

10.

Kamisawa T, Ando H, Hamada Y, Fujii H, Koshinaga T, Urushihara N . Diagnostic criteria for pancreaticobiliary maljunction 2013. J Hepatobiliary Pancreat Sci. 2013; 21(3):159-61. DOI: 10.1002/jhbp.57. View

11.

Kusano T, Takao T, Tachibana K, Tanaka Y, Kamachi M, Ikematsu Y . Whether or not prophylactic excision of the extrahepatic bile duct is appropriate for patients with pancreaticobiliary maljunction without bile duct dilatation. Hepatogastroenterology. 2005; 52(66):1649-53. View

12.

Kamisawa T, Kuruma S, Tabata T, Chiba K, Iwasaki S, Koizumi S . Pancreaticobiliary maljunction and biliary cancer. J Gastroenterol. 2014; 50(3):273-9. DOI: 10.1007/s00535-014-1015-2. View

13.

Kamisawa T, Tu Y, Kuwata G, Egawa N, Nakajima H, Tsuruta K . Biliary carcinoma risk in patients with pancreaticobiliary maljunction and the degree of extrahepatic bile duct dilatation. Hepatogastroenterology. 2006; 53(72):816-8. View

14.

Hanada K, Tsuchida A, Kajiyama G . Cellular kinetics and gene mutations in gallbladder mucosa with an anomalous junction of pancreaticobiliary duct. J Hepatobiliary Pancreat Surg. 1999; 6(3):223-8. DOI: 10.1007/s005340050111. View

15.

Randi G, Franceschi S, La Vecchia C . Gallbladder cancer worldwide: geographical distribution and risk factors. Int J Cancer. 2006; 118(7):1591-602. DOI: 10.1002/ijc.21683. View

16.

Khan Z, Neugut A, Ahsan H, Chabot J . Risk factors for biliary tract cancers. Am J Gastroenterol. 1999; 94(1):149-52. DOI: 10.1111/j.1572-0241.1999.00786.x. View

17.

Soares K, Arnaoutakis D, Kamel I, Rastegar N, Anders R, Maithel S . Choledochal cysts: presentation, clinical differentiation, and management. J Am Coll Surg. 2014; 219(6):1167-80. PMC: 4332770. DOI: 10.1016/j.jamcollsurg.2014.04.023. View

18.

Kimura K, OHTO M, Saisho H, Unozawa T, Tsuchiya Y, Morita M . Association of gallbladder carcinoma and anomalous pancreaticobiliary ductal union. Gastroenterology. 1985; 89(6):1258-65. DOI: 10.1016/0016-5085(85)90641-9. View

19.

Hu B, Gong B, Zhou D . Association of anomalous pancreaticobiliary ductal junction with gallbladder carcinoma in Chinese patients: an ERCP study. Gastrointest Endosc. 2003; 57(4):541-5. DOI: 10.1067/mge.2003.136. View

20.

Tokiwa K, Ono S, Iwai N . Mucosal cell proliferation activity of the gallbladder in children with anomalous arrangement of the pancreaticobiliary duct. J Hepatobiliary Pancreat Surg. 1999; 6(3):213-7. DOI: 10.1007/s005340050109. View