{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T04:30:27Z","timestamp":1770611427798,"version":"3.49.0"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T00:00:00Z","timestamp":1753833600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T00:00:00Z","timestamp":1753833600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"name":"Featured Clinical Discipline Project of Shanghai Pudong District","award":["PWYts2021-06"],"award-info":[{"award-number":["PWYts2021-06"]}]},{"name":"Shanghai East Hospital Clinical Research Project","award":["DFLC2022019"],"award-info":[{"award-number":["DFLC2022019"]}]},{"name":"Shanghai East Hospital Research Initiation Fund","award":["DFRC2018014"],"award-info":[{"award-number":["DFRC2018014"]}]},{"name":"Key Specialty Construction Project of Shanghai Pudong New Area Health Commission","award":["PWZzk2022-17"],"award-info":[{"award-number":["PWZzk2022-17"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Gastroenterol"],"DOI":"10.1186\/s12876-025-04131-3","type":"journal-article","created":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T08:29:44Z","timestamp":1753864184000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Risk factors and clinical characteristics of occult pancreaticobiliary reflux in benign gallbladder diseases"],"prefix":"10.1186","volume":"25","author":[{"given":"Yukai","family":"Xiang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen","family":"Qiu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hai","family":"Hu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingli","family":"Cai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gang","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anhua","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anan","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chuanqi","family":"He","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yulong","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhaoyan","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,7,30]]},"reference":[{"issue":"7","key":"4131_CR1","doi-asserted-by":"publisher","first-page":"731","DOI":"10.1007\/s00535-012-0611-2","volume":"47","author":"T Kamisawa","year":"2012","unstructured":"Kamisawa T, Ando H, Suyama M, Shimada M, Morine Y, Shimada H. Japanese clinical practice guidelines for pancreaticobiliary maljunction. J Gastroenterol. 2012;47(7):731\u201359.","journal-title":"J Gastroenterol"},{"issue":"3","key":"4131_CR2","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1002\/jhbp.57","volume":"21","author":"T Kamisawa","year":"2014","unstructured":"Kamisawa T, Ando H, Hamada Y, Fujii H, Koshinaga T, Urushihara N, Itoi T, Shimada H. Diagnostic criteria for pancreaticobiliary maljunction 2013. J Hepato-Biliary-Pancreat Sci. 2014;21(3):159\u201361.","journal-title":"J Hepato-Biliary-Pancreat Sci"},{"issue":"2","key":"4131_CR3","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1007\/s00535-016-1268-z","volume":"52","author":"T Kamisawa","year":"2017","unstructured":"Kamisawa T, Kuruma S, Chiba K, Tabata T, Koizumi S, Kikuyama M. Biliary carcinogenesis in pancreaticobiliary maljunction. J Gastroenterol. 2017;52(2):158\u201363.","journal-title":"J Gastroenterol"},{"issue":"4","key":"4131_CR4","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1016\/j.ijsu.2012.02.009","volume":"10","author":"MA Beltr\u00e1n","year":"2012","unstructured":"Beltr\u00e1n MA. Current knowledge on pancreaticobiliary reflux in normal pancreaticobiliary junction. Int J Surg (London England). 2012;10(4):190\u20133.","journal-title":"Int J Surg (London England)"},{"issue":"5","key":"4131_CR5","doi-asserted-by":"publisher","first-page":"875","DOI":"10.1007\/s00535-013-0837-7","volume":"49","author":"J Horaguchi","year":"2014","unstructured":"Horaguchi J, Fujita N, Kamisawa T, Honda G, Chijiiwa K, Maguchi H, Tanaka M, Shimada M, Igarashi Y, Inui K, et al. Pancreatobiliary reflux in individuals with a normal pancreaticobiliary junction: a prospective multicenter study. J Gastroenterol. 2014;49(5):875\u201381.","journal-title":"J Gastroenterol"},{"issue":"8","key":"4131_CR6","doi-asserted-by":"publisher","first-page":"953","DOI":"10.3748\/wjg.v17.i8.953","volume":"17","author":"MA Beltr\u00e1n","year":"2011","unstructured":"Beltr\u00e1n MA. Pancreaticobiliary reflux in patients with a normal pancreaticobiliary junction: pathologic implications. World J Gastroenterol. 2011;17(8):953\u201362.","journal-title":"World J Gastroenterol"},{"issue":"2","key":"4131_CR7","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1016\/S0016-5107(04)02586-6","volume":"61","author":"JK Sai","year":"2005","unstructured":"Sai JK, Suyama M, Nobukawa B, Kubokawa Y, Yokomizo K, Sato N. Precancerous mucosal changes in the gallbladder of patients with occult pancreatobiliary reflux. Gastrointest Endosc. 2005;61(2):264\u20138.","journal-title":"Gastrointest Endosc"},{"issue":"3","key":"4131_CR8","first-page":"425","volume":"15","author":"T Itoi","year":"2005","unstructured":"Itoi T, Tsuchida A, Itokawa F, Sofuni A, Kurihara T, Tsuchiya T, Moriyasu F, Kasuya K, Serizawa H. Histologic and genetic analysis of the gallbladder in patients with occult pancreatobiliary reflux. Int J Mol Med. 2005;15(3):425\u201330.","journal-title":"Int J Mol Med"},{"issue":"5","key":"4131_CR9","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1007\/s00534-002-0741-7","volume":"10","author":"S Tashiro","year":"2003","unstructured":"Tashiro S, Imaizumi T, Ohkawa H, Okada A, Katoh T, Kawaharada Y, Shimada H, Takamatsu H, Miyake H, Todani T. Pancreaticobiliary maljunction: retrospective and nationwide survey in Japan. J Hepato-biliary-Pancreat Surg. 2003;10(5):345\u201351.","journal-title":"J Hepato-biliary-Pancreat Surg"},{"issue":"2","key":"4131_CR10","doi-asserted-by":"publisher","first-page":"101","DOI":"10.4174\/jkss.2013.84.2.101","volume":"84","author":"SP Yun","year":"2013","unstructured":"Yun SP, Lee JY, Jo HJ, Kim HS, Kim DH, Kim JH, Park SJ, Park DY, Seo HI. Long-term follow-up May be needed for pancreaticobiliary reflux in healthy adults. J Korean Surg Soc. 2013;84(2):101\u20136.","journal-title":"J Korean Surg Soc"},{"issue":"2","key":"4131_CR11","doi-asserted-by":"publisher","first-page":"172","DOI":"10.5009\/gnl.2012.6.2.172","volume":"6","author":"LM Stinton","year":"2012","unstructured":"Stinton LM, Shaffer EA. Epidemiology of gallbladder disease: cholelithiasis and cancer. Gut Liver. 2012;6(2):172\u201387.","journal-title":"Gut Liver"},{"key":"4131_CR12","first-page":"99","volume":"6","author":"R Hundal","year":"2014","unstructured":"Hundal R, Shaffer EA. Gallbladder cancer: epidemiology and outcome. Clin Epidemiol. 2014;6:99\u2013109.","journal-title":"Clin Epidemiol"},{"issue":"23","key":"4131_CR13","doi-asserted-by":"publisher","first-page":"1600","DOI":"10.21037\/atm-20-4897","volume":"8","author":"KF Lee","year":"2020","unstructured":"Lee KF, Hung EHY, Leung HHW, Lai PBS. A narrative review of gallbladder adenomyomatosis: what we need to know. Annals Translational Med. 2020;8(23):1600.","journal-title":"Annals Translational Med"},{"issue":"Suppl 4","key":"4131_CR14","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1111\/jgh.12241","volume":"28","author":"S Tazuma","year":"2013","unstructured":"Tazuma S, Kanno K, Sugiyama A, Kishikawa N. Nutritional factors (nutritional aspects) in biliary disorders: bile acid and lipid metabolism in gallstone diseases and pancreaticobiliary maljunction. J Gastroenterol Hepatol. 2013;28(Suppl 4):103\u20137.","journal-title":"J Gastroenterol Hepatol"},{"issue":"3","key":"4131_CR15","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1136\/gut.20.3.216","volume":"20","author":"LA Donaldson","year":"1979","unstructured":"Donaldson LA, Joffe SN, McIntosh W, Brodie MJ. Amylase activity in human bile. Gut. 1979;20(3):216\u20138.","journal-title":"Gut"},{"issue":"12","key":"4131_CR16","doi-asserted-by":"publisher","first-page":"2915","DOI":"10.1007\/s00268-010-0771-2","volume":"34","author":"MA Beltr\u00e1n","year":"2010","unstructured":"Beltr\u00e1n MA, Contreras MA, Cruces KS. Pancreaticobiliary reflux in patients with and without cholelithiasis: is it a normal phenomenon? World J Surg. 2010;34(12):2915\u201321.","journal-title":"World J Surg"},{"issue":"2","key":"4131_CR17","first-page":"245","volume":"1865","author":"JA Espinoza","year":"2016","unstructured":"Espinoza JA, Bizama C, Garc\u00eda P, Ferreccio C, Javle M, Miquel JF, Koshiol J, Roa JC. The inflammatory inception of gallbladder cancer. Biochim Biophys Acta. 2016;1865(2):245\u201354.","journal-title":"Biochim Biophys Acta"},{"issue":"4","key":"4131_CR18","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1002\/bjs.1800770403","volume":"77","author":"MC Aldridge","year":"1990","unstructured":"Aldridge MC, Bismuth H. Gallbladder cancer: the polyp-cancer sequence. Br J Surg. 1990;77(4):363\u20134.","journal-title":"Br J Surg"},{"issue":"6","key":"4131_CR19","doi-asserted-by":"publisher","first-page":"2080","DOI":"10.1002\/hep.27715","volume":"61","author":"R Poupon","year":"2015","unstructured":"Poupon R. Liver alkaline phosphatase: a missing link between choleresis and biliary inflammation. Hepatology (Baltimore MD). 2015;61(6):2080\u201390.","journal-title":"Hepatology (Baltimore MD)"},{"issue":"12","key":"4131_CR20","doi-asserted-by":"publisher","first-page":"1723","DOI":"10.1111\/liv.13221","volume":"36","author":"SK Kunutsor","year":"2016","unstructured":"Kunutsor SK. Gamma-glutamyltransferase-friend or foe within? Liver International: Official J Int Association Study Liver. 2016;36(12):1723\u201334.","journal-title":"Liver International: Official J Int Association Study Liver"},{"issue":"1","key":"4131_CR21","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1186\/s12944-021-01527-4","volume":"20","author":"YK Xiang","year":"2021","unstructured":"Xiang YK, Kong XY, Zhang C, He CQ, Cai JL, Lu RQ, Zhang BS, Lu L, Yang YL. Free fatty acids and triglyceride change in the gallbladder bile of gallstone patients with pancreaticobiliary reflux. Lipids Health Dis. 2021;20(1):97.","journal-title":"Lipids Health Dis"},{"issue":"1","key":"4131_CR22","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1007\/s00534-008-0010-5","volume":"16","author":"T Kamisawa","year":"2009","unstructured":"Kamisawa T, Kurata M, Honda G, Tsuruta K, Okamoto A. Biliopancreatic reflux-pathophysiology and clinical implications. J Hepato-biliary-Pancreat Surg. 2009;16(1):19\u201324.","journal-title":"J Hepato-biliary-Pancreat Surg"},{"issue":"2","key":"4131_CR23","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1111\/j.1440-1746.1998.tb00634.x","volume":"13","author":"S Tanno","year":"1998","unstructured":"Tanno S, Obara T, Maguchi H, Fujii T, Mizukami Y, Shudo R, Takahashi K, Nishino N, Arisato S, Ura H, et al. Association between anomalous pancreaticobiliary ductal union and adenomyomatosis of the gall-bladder. J Gastroenterol Hepatol. 1998;13(2):175\u201380.","journal-title":"J Gastroenterol Hepatol"},{"issue":"24","key":"4131_CR24","first-page":"2016","volume":"45","author":"LY Chang","year":"1998","unstructured":"Chang LY, Wang HP, Wu MS, Huang HT, Wang HH, Lin CC, Lin JT. Anomalous pancreaticobiliary ductal union\u2013an etiologic association of gallbladder cancer and adenomyomatosis. Hepatogastroenterology. 1998;45(24):2016\u20139.","journal-title":"Hepatogastroenterology"},{"issue":"16","key":"4131_CR25","first-page":"1230","volume":"103","author":"YK Xiang","year":"2023","unstructured":"Xiang YK, Zhang C, Yang YL, Hu H, Huang AH, Zhao G, Cai JL, Xu AA, Tian FZ, Qiu C, et al. [Clinical analysis of the correlation between gallbladder adenomyomatosis and occult pancreaticobiliary reflux]. Zhonghua Yi Xue Za Zhi. 2023;103(16):1230\u20135.","journal-title":"Zhonghua Yi Xue Za Zhi"},{"issue":"5","key":"4131_CR26","doi-asserted-by":"publisher","first-page":"588","DOI":"10.1046\/j.1365-2168.1999.01121.x","volume":"86","author":"DN Lobo","year":"1999","unstructured":"Lobo DN, Balfour TW, Iftikhar SY, Rowlands BJ. Periampullary diverticula and pancreaticobiliary disease. Br J Surg. 1999;86(5):588\u201397.","journal-title":"Br J Surg"},{"issue":"9","key":"4131_CR27","doi-asserted-by":"publisher","first-page":"994","DOI":"10.1080\/003655201750305549","volume":"36","author":"M Sugiyama","year":"2001","unstructured":"Sugiyama M, Atomi Y. Periampullary diverticula cause pancreatobiliary reflux. Scand J Gastroenterol. 2001;36(9):994\u20137.","journal-title":"Scand J Gastroenterol"},{"issue":"6","key":"4131_CR28","doi-asserted-by":"publisher","first-page":"1341","DOI":"10.1016\/S0039-6109(16)45288-6","volume":"70","author":"FG Moody","year":"1990","unstructured":"Moody FG, Calabuig R, Vecchio R, Runkel N. Stenosis of the sphincter of Oddi. Surg Clin North Am. 1990;70(6):1341\u201354.","journal-title":"Surg Clin North Am"},{"issue":"3","key":"4131_CR29","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1016\/0002-9610(79)90055-2","volume":"137","author":"MC Anderson","year":"1979","unstructured":"Anderson MC, Hauman RL, Suriyapa C, Schiller WR. Pancreatic enzyme levels in bile of patients with extrahepatic biliary tract disease. Am J Surg. 1979;137(3):301\u20136.","journal-title":"Am J Surg"},{"issue":"15","key":"4131_CR30","doi-asserted-by":"publisher","first-page":"1132","DOI":"10.1093\/jnci\/89.15.1132","volume":"89","author":"WA Zatonski","year":"1997","unstructured":"Zatonski WA, Lowenfels AB, Boyle P, Maisonneuve P, Bueno de Mesquita HB, Ghadirian P, Jain M, Przewozniak K, Baghurst P, Moerman CJ, et al. Epidemiologic aspects of gallbladder cancer: a case-control study of the SEARCH program of the international agency for research on Cancer. J Natl Cancer Inst. 1997;89(15):1132\u20138.","journal-title":"J Natl Cancer Inst"},{"issue":"6","key":"4131_CR31","doi-asserted-by":"publisher","first-page":"514","DOI":"10.1016\/j.ejso.2010.05.002","volume":"36","author":"SV Shrikhande","year":"2010","unstructured":"Shrikhande SV, Barreto SG, Singh S, Udwadia TE, Agarwal AK. Cholelithiasis in gallbladder cancer: coincidence, cofactor, or cause! Eur J Surg Oncol. 2010;36(6):514\u20139.","journal-title":"Eur J Surg Oncol"},{"issue":"6","key":"4131_CR32","doi-asserted-by":"publisher","first-page":"1053","DOI":"10.1016\/j.bpg.2006.03.007","volume":"20","author":"C J\u00fcngst","year":"2006","unstructured":"J\u00fcngst C, Kullak-Ublick GA, J\u00fcngst D. Gallstone disease: microlithiasis and sludge. Best Pract Res Clin Gastroenterol. 2006;20(6):1053\u201362.","journal-title":"Best Pract Res Clin Gastroenterol"},{"issue":"4","key":"4131_CR33","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1016\/j.livres.2018.10.001","volume":"2","author":"HH Wang","year":"2018","unstructured":"Wang HH, Portincasa P, Liu M, Tso P, Wang DQ. Similarities and differences between biliary sludge and microlithiasis: their clinical and pathophysiological significances. Liver Res. 2018;2(4):186\u201399.","journal-title":"Liver Res"},{"issue":"2","key":"4131_CR34","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1053\/j.gastro.2008.12.031","volume":"136","author":"KJ Maurer","year":"2009","unstructured":"Maurer KJ, Carey MC, Fox JG. Roles of infection, inflammation, and the immune system in cholesterol gallstone formation. Gastroenterology. 2009;136(2):425\u201340.","journal-title":"Gastroenterology"}],"container-title":["BMC Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-025-04131-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12876-025-04131-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-025-04131-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T07:37:25Z","timestamp":1757317045000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcgastroenterol.biomedcentral.com\/articles\/10.1186\/s12876-025-04131-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,30]]},"references-count":34,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["4131"],"URL":"https:\/\/doi.org\/10.1186\/s12876-025-04131-3","relation":{},"ISSN":["1471-230X"],"issn-type":[{"value":"1471-230X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,30]]},"assertion":[{"value":"8 December 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 June 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 July 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was conducted in accordance with the Declaration of Helsinki, and approved by Shanghai East Hospital Ethics Committee (approval No. 2019tjdx46). Informed consent was obtained from all subjects involved in the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"542"}}