{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T00:25:50Z","timestamp":1768004750753,"version":"3.49.0"},"reference-count":37,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,2,8]],"date-time":"2017-02-08T00:00:00Z","timestamp":1486512000000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["15K10186"],"award-info":[{"award-number":["15K10186"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Elevated bile amylase level in patients with pancreaticobiliary maljunction (<jats:styled-content style=\"fixed-case\">PBM<\/jats:styled-content>) or high confluence of pancreaticobiliary ducts (<jats:styled-content style=\"fixed-case\">HCPBD<\/jats:styled-content>) is well known as a risk factor for gallbladder carcinoma (<jats:styled-content style=\"fixed-case\">GBC<\/jats:styled-content>) development. However, the effects of occult pancreaticobiliary reflux (<jats:styled-content style=\"fixed-case\">OPR<\/jats:styled-content>), a condition characterized by high bile amylase level in the presence of an anatomically normal pancreaticobiliary junction, on <jats:styled-content style=\"fixed-case\">GBC<\/jats:styled-content> development remain unclear. The aim of this study was to assess the relationship between <jats:styled-content style=\"fixed-case\">OPR<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">GBC<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Clinicopathological data of 52 patients who were preoperatively diagnosed with gallbladder (<jats:styled-content style=\"fixed-case\">GB<\/jats:styled-content>) tumor (22 malignant, 30 benign) were retrospectively reviewed. All of the patients underwent preoperative endoscopic retrograde cholangiopancreatography to evaluate pancreaticobiliary junction morphology and bile amylase level. The relationship between the histological diagnosis of <jats:styled-content style=\"fixed-case\">GB<\/jats:styled-content> lesions, and pancreaticobiliary junction morphology and bile amylase level were investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Pancreaticobiliary maljunction, <jats:styled-content style=\"fixed-case\">HCPBD<\/jats:styled-content>, and normal pancreaticobiliary junction (<jats:styled-content style=\"fixed-case\">NPJ<\/jats:styled-content>) were identified in 12, nine, and 31 patients, respectively. The rates of <jats:styled-content style=\"fixed-case\">GBC<\/jats:styled-content> in patients with <jats:styled-content style=\"fixed-case\">PBM<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> HCPBD<\/jats:styled-content>, and <jats:styled-content style=\"fixed-case\">NPJ<\/jats:styled-content> were 58% (7\/12), 67% (6\/9), and 29% (9\/31), respectively. Of the 31 patients with <jats:styled-content style=\"fixed-case\">NPJ<\/jats:styled-content>, 22 had <jats:styled-content style=\"fixed-case\">OPR<\/jats:styled-content> and nine of these had <jats:styled-content style=\"fixed-case\">GBC<\/jats:styled-content>. None of the patients with <jats:styled-content style=\"fixed-case\">NPJ<\/jats:styled-content> and normal bile amylase level had <jats:styled-content style=\"fixed-case\">GBC<\/jats:styled-content>. Additionally, among patients with <jats:styled-content style=\"fixed-case\">NPJ<\/jats:styled-content>, bile amylase level was significantly higher in patients with <jats:styled-content style=\"fixed-case\">GBC<\/jats:styled-content> than in patients with benign tumors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Occult pancreaticobiliary reflux, like <jats:styled-content style=\"fixed-case\">PBM<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">HCPBD<\/jats:styled-content>, is a risk factor for <jats:styled-content style=\"fixed-case\">GBC<\/jats:styled-content> development.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhbp.421","type":"journal-article","created":{"date-parts":[[2016,12,21]],"date-time":"2016-12-21T22:39:07Z","timestamp":1482359947000},"page":"103-108","source":"Crossref","is-referenced-by-count":12,"title":["Elevated bile amylase level without pancreaticobiliary maljunction is a risk factor for gallbladder 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