Assessment of occult pancreatobiliary reflux in patients with pancreaticobiliary disease by ERCP

Journal of Gastroenterology
Fumihide ItokawaTatsuya Aoki


The aim of this study was to evaluate the degree of occult pancreatobiliary reflux by measuring the biliary amylase levels in the common bile duct (CBDA) and gallbladder (GBA) at endoscopic retrograde cholangiopancreatography (ERCP). Eligible patients included 86 consecutive cases of pancreaticobiliary disease with prospective implementation of bile collection during an ERCP procedure. Patients with pancreatobiliary maljunction (PBM) were excluded. Nineteen cases of eligible patients had simultaneous collection of gallbladder bile. Bile was further collected by cholecystectomy in 8 cases. Twenty-two cases (26%) revealed a CBDA level higher than serum amylase (high bile amylase level, HBA group) and 64 cases exhibited a CBDA level lower than serum (LBA group). The mean values of CBDA in the HBA and LBA groups were 5502 IU/l and 29 IU/l, respectively. The rate of HBA was significantly higher in patients who were elderly, had a dilated common bile duct, and those with choledocholithiasis (P <0.05). Three cases (16%) showed a CBDA greater than twice the GBA. Eleven cases (58%) exhibited a GBA higher than the CBDA. The values of GBA obtained during ERCP and cholecystectomy were consistent. These findings suggest that even non-PBM ca...Continue Reading


Nov 27, 2008·World Journal of Gastroenterology : WJG·Terumi KamisawaKouji Tsuruta
May 7, 2008·Journal of Gastroenterology·Jun HoraguchiYoshihiro Harada
Jun 23, 2012·Journal of Gastroenterology·Terumi KamisawaUNKNOWN Japanese Study Group on Pancreaticobiliary Maljunction
Jun 6, 2013·Journal of Gastroenterology·Jun HoraguchiUNKNOWN committee of Diagnostic Criteria of The Japanese Study Group on Pancreaticobiliary Maljunction
Sep 3, 2010·World Journal of Surgery·Marcelo A BeltránKarina S Cruces
Apr 16, 2010·Journal of Hepato-biliary-pancreatic Sciences·Terumi KamisawaUNKNOWN Committee of Diagnostic Criteria of The Japanese Study Group on Pancreaticobiliary
Jul 26, 2006·The Journal of Surgical Research·Tomohiko AdachiTakashi Kanematsu
Dec 22, 2016·Journal of Hepato-biliary-pancreatic Sciences·Takaaki FujimotoMasafumi Nakamura
Feb 12, 2013·Journal of the Korean Surgical Society·Sung-Pil YunHyung-Il Seo
Mar 9, 2007·Journal of Surgical Oncology·Marcelo A BeltránTatiana Danilova
Oct 12, 2007·Journal of Surgical Oncology·Mark D McKee
Oct 3, 2007·Journal of Hepato-biliary-pancreatic Surgery·Mitsuhiro InagakiShinichi Kasai
Apr 21, 2007·Pancreas·Marcelo A Beltrán, Carlos Barría
Mar 12, 2020·Japanese Journal of Radiology·Reiji SugitaYutaka Noda

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