Abstract
In 1983 patients underwent cholecystectomy, total amylase concentration of the gallbladder bile was measured.158 patients total amylase value was over 1,000 IU/L. In 73 of 158 patients, gallbladder was not visualized by direct cholangiography. In another 85 patients,35 patients had common bile duct stone,8 with maljunction of the pancreatobiliary ducts,3 with duodenal diverticulum adjacent to the papilla of Vater, and in remaining 39 patients both the bile and pancreatic ducts were visualized by cholangiography. Those 85 patients were considered as the pathological common bile duct that produces high amylase concentration due to reflux of pancreatic juice into the bile.
In 103 of 158 patients the gallbladder was histologically examined. The gallbladder mucosa showed metaplasia in 92.2%, dysplasia in 14.6%, and hyperplasia in 1.9%. These findings in patients with latent maljunction suggest reflux of pancreatic juice into the gallbladder. Relation between biliary malignancies and the reflux was not defined in this study.
