{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T10:03:11Z","timestamp":1760781791602,"version":"3.41.0"},"reference-count":34,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2015,3,10]],"date-time":"2015-03-10T00:00:00Z","timestamp":1425945600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Asian J Endoscop Surgery"],"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Bile reflux into the pancreatic duct (<jats:styled-content style=\"fixed-case\">BRPD<\/jats:styled-content>) is sometimes demonstrated during intraoperative cholangiography (<jats:styled-content style=\"fixed-case\">IOC<\/jats:styled-content>) even in patients without pancreaticobiliary maljunction. However, the clinical significance of this finding in laparoscopic and open cholecystectomy is unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Among 484 patients who underwent cholecystectomy (372 laparoscopic, 112 open), patients whose pancreatic duct was depicted in<jats:styled-content style=\"fixed-case\">IOC<\/jats:styled-content>were selected. The value of pancreatic amylase (p\u2010amylase) of the gallbladder bile, histological changes, and the immunohistochemical expression of proliferating cell nuclear antigen (<jats:styled-content style=\"fixed-case\">PCNA<\/jats:styled-content>) in the gallbladder mucosa were analyzed in patients with BRPD. The data were then compared to those in patients without<jats:styled-content style=\"fixed-case\">BRPD<\/jats:styled-content>whose gallbladder bile p\u2010amylase was measured (control group,<jats:italic>n<\/jats:italic>\u2009=\u200920).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The success rate of<jats:styled-content style=\"fixed-case\">IOC<\/jats:styled-content>was 93.6%. The rate of<jats:styled-content style=\"fixed-case\">BRPD<\/jats:styled-content>in laparoscopic and open cholecystectomy was 5.2% and 5.7%, respectively. The value of gallbladder bile p\u2010amylase in patients with BRPD was significantly higher than in the control group (790.5 vs 14.0\u2009IU\/L,<jats:italic>P<\/jats:italic>\u2009=\u20090.034). The value of the<jats:styled-content style=\"fixed-case\">PCNA<\/jats:styled-content>labeling index in patients with<jats:styled-content style=\"fixed-case\">BRPD<\/jats:styled-content>was significantly higher than that of the control group (15.4% vs 4.1%,<jats:italic>P<\/jats:italic>\u2009=\u20090.0026). Among the 24 patients with<jats:styled-content style=\"fixed-case\">BRPD<\/jats:styled-content>, pathological changes in the gallbladder mucosa were detected in five (two hyperplasia, three metaplasia), but there was no correlation between the presence of pathological change and<jats:styled-content style=\"fixed-case\">PCNA<\/jats:styled-content>labeling index or gallbladder bile p\u2010amylase.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">IOC<\/jats:styled-content>could detect<jats:styled-content style=\"fixed-case\">BRPD<\/jats:styled-content>both in laparoscopic and open cholecystectomy at a similar rate. Patients with<jats:styled-content style=\"fixed-case\">BRPD<\/jats:styled-content>had high levels of gallbladder bile p\u2010amylase and<jats:styled-content style=\"fixed-case\">PCNA<\/jats:styled-content>labeling index, findings similar to those in patients with pancreaticobiliary maljunction.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ases.12181","type":"journal-article","created":{"date-parts":[[2015,3,10]],"date-time":"2015-03-10T09:17:29Z","timestamp":1425979049000},"page":"296-302","source":"Crossref","is-referenced-by-count":5,"title":["Clinical significance of bile reflux into the pancreatic duct without pancreaticobiliary maljunction assessed by intraoperative cholangiography"],"prefix":"10.1111","volume":"8","author":[{"given":"Kimihiko","family":"Ueno","sequence":"first","affiliation":[{"name":"Department of Surgery, Division of Hepato\u2010Biliary\u2010Pancreatic Surgery Kobe University Graduate School of Medicine Kobe 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