Studies on biliary tract carcinoma in the case with pancreaticobiliary maljunction

Hitoshi Hara, Shinsho Morita, Takashi Ishibashi, Shozo Sako, Takehiko Dohi, Masahiro Otani, Mitsuhiko Iwamoto, Hitoshi Inoue, Nobuhiko Tanigawa

Research output: Contribution to journalArticle

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Abstract

Background/Aims: The purpose of this study was to clarify the clinicopathological features of pancreaticobiliary maljunction and to determine the appropriate surgical approach for biliary tract with pancreaticobiliary maljunction. Methodology: The data of 77 patients with pancreaticobiliary maljunction including 13, who had been treated for biliary tract cancer, were reviewed retrospectively. We assessed the clinical features, biological characteristics of the cancer, methods of surgical treatment, postoperative outcome and cell proliferating activity of the biliary epithelium, evaluated by the PCNALI (proliferating cell nuclear antigen-labeling index). Results: The incidence of cancer development in the case with pancreaticobiliary maljunction was 13.4% in the bile duct dilatation group (n=67) and 40.0% in the non-dilatation group (n=10). Dissection of lymphadenectomy was performed in 10 (76.9%) of 13 patients, and curative resection was feasible in 9 of the 10 patients. Two (20.0%) of the 10 patients had lymph node involvement noted at surgery and died of recurrence. In the other eight patients without lymph node involvement at surgery, six patients underwent curative resection and are alive at 7 months to 11 years and 6 months after surgery. PCNALI of the biliary epithelium of the patients with pancreaticobiliary maljunction was significantly higher than that of the control group. Conclusions: For patients with pancreaticobiliary maljunction, it should be stressed that the extrahepatic bile duct be prophylactically removed, even when there are no neoplasmatic changes because of high prevalence of cancer development, presumably predicted by the increase of cell proliferative activity in the biliary epithelium. For patients with biliary cancer, early detection at the stage with no lymph node involvement is essential to secure for long-term survival.

Original languageEnglish (US)
Pages (from-to)104-108
Number of pages5
JournalHepato-Gastroenterology
Volume49
Issue number43
StatePublished - Apr 18 2002

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Biliary Tract
Carcinoma
Biliary Tract Neoplasms
Epithelium
Lymph Nodes
Proliferating Cell Nuclear Antigen
Extrahepatic Bile Ducts
Neoplasms
Bile Ducts
Lymph Node Excision
Early Detection of Cancer
Dissection
Dilatation
Recurrence
Control Groups
Survival
Incidence

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

Hara, H., Morita, S., Ishibashi, T., Sako, S., Dohi, T., Otani, M., ... Tanigawa, N. (2002). Studies on biliary tract carcinoma in the case with pancreaticobiliary maljunction. Hepato-Gastroenterology, 49(43), 104-108.
Hara, Hitoshi ; Morita, Shinsho ; Ishibashi, Takashi ; Sako, Shozo ; Dohi, Takehiko ; Otani, Masahiro ; Iwamoto, Mitsuhiko ; Inoue, Hitoshi ; Tanigawa, Nobuhiko. / Studies on biliary tract carcinoma in the case with pancreaticobiliary maljunction. In: Hepato-Gastroenterology. 2002 ; Vol. 49, No. 43. pp. 104-108.
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abstract = "Background/Aims: The purpose of this study was to clarify the clinicopathological features of pancreaticobiliary maljunction and to determine the appropriate surgical approach for biliary tract with pancreaticobiliary maljunction. Methodology: The data of 77 patients with pancreaticobiliary maljunction including 13, who had been treated for biliary tract cancer, were reviewed retrospectively. We assessed the clinical features, biological characteristics of the cancer, methods of surgical treatment, postoperative outcome and cell proliferating activity of the biliary epithelium, evaluated by the PCNALI (proliferating cell nuclear antigen-labeling index). Results: The incidence of cancer development in the case with pancreaticobiliary maljunction was 13.4{\%} in the bile duct dilatation group (n=67) and 40.0{\%} in the non-dilatation group (n=10). Dissection of lymphadenectomy was performed in 10 (76.9{\%}) of 13 patients, and curative resection was feasible in 9 of the 10 patients. Two (20.0{\%}) of the 10 patients had lymph node involvement noted at surgery and died of recurrence. In the other eight patients without lymph node involvement at surgery, six patients underwent curative resection and are alive at 7 months to 11 years and 6 months after surgery. PCNALI of the biliary epithelium of the patients with pancreaticobiliary maljunction was significantly higher than that of the control group. Conclusions: For patients with pancreaticobiliary maljunction, it should be stressed that the extrahepatic bile duct be prophylactically removed, even when there are no neoplasmatic changes because of high prevalence of cancer development, presumably predicted by the increase of cell proliferative activity in the biliary epithelium. For patients with biliary cancer, early detection at the stage with no lymph node involvement is essential to secure for long-term survival.",
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Hara, H, Morita, S, Ishibashi, T, Sako, S, Dohi, T, Otani, M, Iwamoto, M, Inoue, H & Tanigawa, N 2002, 'Studies on biliary tract carcinoma in the case with pancreaticobiliary maljunction', Hepato-Gastroenterology, vol. 49, no. 43, pp. 104-108.

Studies on biliary tract carcinoma in the case with pancreaticobiliary maljunction. / Hara, Hitoshi; Morita, Shinsho; Ishibashi, Takashi; Sako, Shozo; Dohi, Takehiko; Otani, Masahiro; Iwamoto, Mitsuhiko; Inoue, Hitoshi; Tanigawa, Nobuhiko.

In: Hepato-Gastroenterology, Vol. 49, No. 43, 18.04.2002, p. 104-108.

Research output: Contribution to journalArticle

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T1 - Studies on biliary tract carcinoma in the case with pancreaticobiliary maljunction

AU - Hara, Hitoshi

AU - Morita, Shinsho

AU - Ishibashi, Takashi

AU - Sako, Shozo

AU - Dohi, Takehiko

AU - Otani, Masahiro

AU - Iwamoto, Mitsuhiko

AU - Inoue, Hitoshi

AU - Tanigawa, Nobuhiko

PY - 2002/4/18

Y1 - 2002/4/18

N2 - Background/Aims: The purpose of this study was to clarify the clinicopathological features of pancreaticobiliary maljunction and to determine the appropriate surgical approach for biliary tract with pancreaticobiliary maljunction. Methodology: The data of 77 patients with pancreaticobiliary maljunction including 13, who had been treated for biliary tract cancer, were reviewed retrospectively. We assessed the clinical features, biological characteristics of the cancer, methods of surgical treatment, postoperative outcome and cell proliferating activity of the biliary epithelium, evaluated by the PCNALI (proliferating cell nuclear antigen-labeling index). Results: The incidence of cancer development in the case with pancreaticobiliary maljunction was 13.4% in the bile duct dilatation group (n=67) and 40.0% in the non-dilatation group (n=10). Dissection of lymphadenectomy was performed in 10 (76.9%) of 13 patients, and curative resection was feasible in 9 of the 10 patients. Two (20.0%) of the 10 patients had lymph node involvement noted at surgery and died of recurrence. In the other eight patients without lymph node involvement at surgery, six patients underwent curative resection and are alive at 7 months to 11 years and 6 months after surgery. PCNALI of the biliary epithelium of the patients with pancreaticobiliary maljunction was significantly higher than that of the control group. Conclusions: For patients with pancreaticobiliary maljunction, it should be stressed that the extrahepatic bile duct be prophylactically removed, even when there are no neoplasmatic changes because of high prevalence of cancer development, presumably predicted by the increase of cell proliferative activity in the biliary epithelium. For patients with biliary cancer, early detection at the stage with no lymph node involvement is essential to secure for long-term survival.

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Hara H, Morita S, Ishibashi T, Sako S, Dohi T, Otani M et al. Studies on biliary tract carcinoma in the case with pancreaticobiliary maljunction. Hepato-Gastroenterology. 2002 Apr 18;49(43):104-108.