| Theme | Recent Issues of Pancreaticobiliary Maljunction | |
|---|---|---|
| Title | Pancreaticobiliary Maljunction without Bile Duct Dilatation -- Cholecystectomy as a Treatment of Choice and Related Problems | |
| Publish Date | 2002/09 | |
| Author | Jiro Ohuchida | Department of Surgery 1, Miyazaki Medical College |
| Author | Kazuo Chijiiwa | Department of Surgery 1, Miyazaki Medical College |
| Author | Yukio Sonoda | Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University |
| Author | Masahiko Kawamoto | Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University |
| Author | Hiroyuki Konomi | Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University |
| Author | Masao Tanaka | Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University |
| [ Summary ] | Prophylactic resection of the gallbladder together with bile duct dilation, resulting in biliary diversion, is now the treatment of choice for pancreaticobiliary maljunction (PBMJ) with bile duct dilatation, because of the high risk of biliary tract carcinoma. However, methods of treatment for PBMJ without bile duct dilatation are still controversial. The incidence of gallbladder carcinoma in patients with PBMJ without bile duct dilatation is higher than that in those with bile duct dilatation. Of 146 patients with PBMJ, 4O (27.4%) patients (28 women and 12 men) did not receive bile duct dilatation, their mean age at diagnosis was 52.2 years old, ranging from 4 to 82. Follow ups were completed in 35 out of these 40 patients. Gallbladder carcinoma was found in 15 (42.9%) of the 35 patients, while none had bile duct carcinoma. After prophylactic cholecystectomy in the 16 patients with out gallbladder carcinoma, none developed bile duct carcinoma during the mean follow up period of 7 years after cholecystectomy. Eight of the 15 patients had stage IV gallbladder carcinoma and their prognosis was poor. Prophylactic cholecystectomy is the treatment of choice for patients with PBMJ without bileduct dilatation, and special attention to the possible presence of gallbladder carcinoma is mandatory for such patients. | |