{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T12:31:35Z","timestamp":1790771495775,"version":"4.1.0"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,2,19]],"date-time":"2019-02-19T00:00:00Z","timestamp":1550534400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Gastroent Surgery"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>\n                      Pancreaticobiliary maljunction (PBM) with or without congenital biliary dilatation (\n                      <jats:styled-content style=\"fixed-case\">CBD<\/jats:styled-content>\n                      ) is a risk factor for biliary tract cancer. We investigated long\u2010term outcomes after biliary diversion operation with special reference to types of\n                      <jats:styled-content style=\"fixed-case\">CBD<\/jats:styled-content>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Subjects comprised 40 adult patients who underwent biliary diversion operation for PBM without biliary tract cancer. Group A comprised 20 patients with type Ia or Ic\n                      <jats:styled-content style=\"fixed-case\">CBD<\/jats:styled-content>\n                      , or non\u2010dilated bile ducts, while group B comprised 20 patients with type\n                      <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content>\n                      \u2010A\n                      <jats:styled-content style=\"fixed-case\">CBD<\/jats:styled-content>\n                      . The clinical findings and postoperative outcomes were compared between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 40 patients, nine patients suffered from repeated cholangitis and eight of these nine patients suffered from hepatolithiasis after biliary diversion operation. Biliary tract cancer or pancreatic cancer was detected in four patients at 3\u00a0years and 2\u00a0months to 24\u00a0years after the operation. In three of these four patients, the serum concentration of carbohydrate antigen 19\u20109 increased before detection of carcinoma. One patient died of hepatic failure due to repeated cholangitis. The proportions of patients with repeated cholangitis, hepatolithiasis, and re\u2010operation, and patients who died of biliary tract cancer, pancreatic cancer, or hepatic failure, were significantly higher in group B than in group A. The survival rate was significantly worse in group B than in group A.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Careful long\u2010term follow\u2010up with measurement of serum tumor markers is necessary after biliary diversion operation for PBM, especially in patients with type\n                      <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content>\n                      \u2010A\n                      <jats:styled-content style=\"fixed-case\">CBD<\/jats:styled-content>\n                      or repeated cholangitis.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ags3.12239","type":"journal-article","created":{"date-parts":[[2019,2,19]],"date-time":"2019-02-19T08:59:49Z","timestamp":1550566789000},"page":"217-223","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Long\u2010term outcomes after biliary diversion operation for pancreaticobiliary maljunction in adult patients"],"prefix":"10.1002","volume":"3","author":[{"given":"Takanori","family":"Aota","sequence":"first","affiliation":[{"name":"Department of Hepato\u2010Biliary\u2010Pancreatic Surgery Osaka City University Graduate School of Medicine  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4353-8033","authenticated-orcid":false,"given":"Shoji","family":"Kubo","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Biliary\u2010Pancreatic Surgery Osaka City University Graduate School of Medicine  Osaka 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University Graduate School of Medicine  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadaaki","family":"Yamazoe","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Biliary\u2010Pancreatic Surgery Osaka City University Graduate School of Medicine  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0164-2414","authenticated-orcid":false,"given":"Hiroji","family":"Shinkawa","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Biliary\u2010Pancreatic Surgery Osaka City University Graduate School of Medicine  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Go","family":"Ohira","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Biliary\u2010Pancreatic Surgery Osaka City University Graduate School of Medicine  Osaka 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