Increased prevalence of pancreaticobiliary maljunction in biliary malignancies

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Hyvärinen , I , Hukkinen , M , Kivisaari , R , Parviainen , H , Nordin , A & Pakarinen , M P 2019 , ' Increased prevalence of pancreaticobiliary maljunction in biliary malignancies ' , Scandinavian Journal of Surgery , vol. 108 , no. 4 , pp. 285-290 . https://doi.org/10.1177/1457496918822617

Title: Increased prevalence of pancreaticobiliary maljunction in biliary malignancies
Author: Hyvärinen, I.; Hukkinen, M.; Kivisaari, R.; Parviainen, H.; Nordin, A.; Pakarinen, M. P.
Contributor: University of Helsinki, Lastenkirurgian yksikkö
University of Helsinki, HUS Children and Adolescents
University of Helsinki, HUS Medical Imaging Center
University of Helsinki, HUS Medical Imaging Center
University of Helsinki, HUS Abdominal Center
University of Helsinki, HUS Children and Adolescents
Date: 2019-12
Language: eng
Number of pages: 6
Belongs to series: Scandinavian Journal of Surgery
ISSN: 1457-4969
URI: http://hdl.handle.net/10138/307174
Abstract: Aim: The incidence of pancreaticobiliary maljunction is thought to approximate 1:100,000 within Western populations. We aimed to study the significance of pancreaticobiliary maljunction in biliary tract malignancies. Methods: Medical records and magnetic resonance cholangiopancreatography images of 252 consecutive patients treated for biliary malignancies during 2005-2016 were reviewed. Patients with other known risk factors for biliary cancers (n = 27) were excluded. A common pancreaticobiliary channel measuring > 10 mm outside the duodenal wall was defined as pancreaticobiliary maljunction. Main Results: Of the 225 patients, a reliably interpretable preoperative magnetic resonance cholangiopancreatography was available for 73 (32%). Sex (47% vs 57% females) and age at diagnosis (67 vs 66 years) were similar among patients with or without an magnetic resonance cholangiopancreatography (p = ns for both). In magnetic resonance cholangiopancreatography, a pancreaticobiliary maljunction with a median length of 20 mm (range 10-23 mm) was identified in four patients (5.5%, 95% confidence interval 1.6-14), while none had evident accompanying biliary tree dilatation. Pancreaticobiliary maljunction patients were significantly more often females (100% vs 43%, p = 0.043), less likely to have intrahepatic bile duct cancer (0% vs 65%, p = 0.019) while more likely to have gallbladder cancer (75% vs 22%, p = 0.044) compared to the others. Age at diagnosis (66 vs 67 years, p = 0.898), extrahepatic bile duct cancer incidence (25% vs 13%, p = 0.453), and survival status at last follow-up (50% vs 42% alive, p = 1.000) were comparable between the subgroups. Conclusion: The prevalence of pancreaticobiliary maljunction is substantially higher in adults with biliary malignancies than one would expect based on its incidence, reinforcing the etiologic role of pancreaticobiliary maljunction especially in females with gallbladder cancer.
Subject: Pancreaticobiliary maljunction
common channel
gallbladder cancer
bile duct cancer
EXTRAHEPATIC BILE-DUCT
CHOLEDOCHAL CYSTS
RISK-FACTORS
CARCINOGENESIS
DILATATION
TRACT
3126 Surgery, anesthesiology, intensive care, radiology
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