Clinical Research
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 7, 2005; 11(13): 1965-1970
Published online Apr 7, 2005. doi: 10.3748/wjg.v11.i13.1965
Amylase level in extrahepatic bile duct in adult patients with choledochal cyst plus anomalous pancreatico-biliary ductal union
In-Ho Jeong, Yong-Sik Jung, Hong Kim, Bong-Wan Kim, Jung-Woon Kim, Jeong Hong, Hee-Jung Wang, Myung-Wook Kim, Byung-Moo Yoo, Jin-Hong Kim, Jae-Ho Han, Wook-Hwan Kim
In-Ho Jeong, Yong-Sik Jung, Hong Kim, Bong-Wan Kim, Jung-Woon Kim, Jeong Hong, Hee-Jung Wang, Myung-Wook Kim, Wook-Hwan Kim, Department of Surgery, Ajou University School of Medicine, Suwon, Korea
Byung-Moo Yoo, Jin-Hong Kim, Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea
Jae-Ho Han, Department of Pathology, Ajou University School of Medicine, Suwon, Korea
Author contributions: All authors contributed equally to the work.
Correspondence to: Wook-Hwan Kim, M.D., Ph.D., Department of Surgery, Ajou University School of Medicine, San-5, Wonchondong, Yeongtonggu, Suwon 442-749, Korea. gimukani@hanmail.net
Telephone: +82-31-219-5207 Fax: +82-31-219-5755
Received: September 21, 2004
Revised: September 22, 2004
Accepted: November 23, 2004
Published online: April 7, 2005
Abstract

AIM: To investigate the relationship between pancreatic amylase in bile duct and the clinico-pathological features in adult patients with choledochal cyst and anomalous pancreatico-biliary ductal union (APBDU).

METHODS: From 39 patients who underwent surgery for choledochal cyst between March 1995 and March 2003, we selected 15 adult patients who had some symptoms and were radiologically diagnosed as APBDU, and their clinico-pathological features were subsequently evaluated retrospectively. However, we could not obtain biliary amylase in all the patients because of the surgeon’s slip. Therefore, we measured the amylase level in gall bladder of 10 patients and in common bile duct of 11 patients.

RESULTS: Levels of amylase in common bile duct and gall bladder ranged from 11500 to 212000 IU/L, and the younger the patients, the higher the biliary amylase level (r = -0.982, P<0.01). Pathologically, significant correlation was found between the size of choledochal cyst and the grade of inflammation (r = 0.798, P<0.01). And, significant correlation was found between the level of amylase in gall bladder and the grade of hyperplasia. On the other hand, there was no correlation to the age of symptomatic onset or inflammatory grade (r = 0.743, P<0.05). Level of lipase was elevated from 6000 to 159000 IU/L in bile duct and from 14400 to 117000 IU/L in the gall bladder; however, there was no significant correlation with age or clinico-pathological features.

CONCLUSION: The results support the notion that amylase has a particular role in the onset of symptoms, and suggest that a large amount of biliary amylase induces early onset of symptom, thereby making early diagnosis possible.

Keywords: Choledochal cyst; Anomalous pancreaticobiliary ductal union; Amylase; Hyperplasia