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Browsing by Author "Hyvärinen, Ilona"

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  • Hyvärinen, Ilona; Hukkinen, Maria; Kivisaari, Reetta; Parviainen, Helka; Nordin, Arno; Pakarinen, Mikko (2018)
    Aim: The incidence of pancreaticobiliary maljunction (PBM) is thought to approximate 1:100,000 within Western populations. We aimed to study the significance of PBM in biliary tract malignancies. Methods: Medical records and magnetic resonance cholangiopancreatography (MRCP) images of 252 consecutive patients treated for biliary malignancies during 2005-2016 were reviewed. Patients with other known risk factors for biliary cancers (n=27) were excluded. A common pancreaticobiliary channel measuring ≥10 mm outside the duodenal wall was defined as PBM. Main results: Of the 225 patients, a reliably interpretable preoperative MRCP was available for 73 (32%). Sex (47% vs. 57% females) and age at diagnosis (67 vs. 66 years) were similar among patients with or without an MRCP (p=ns for both). In MRCP a PBM with a median length of 20mm (range 10-23mm) was identified in four patients (5.5%, 95% confidence interval 1.6-14), while none had evident accompanying biliary tree dilatation. PBM patients were significantly more often females (100% vs. 43%, p=0.043), less likely to have intrahepatic bile duct cancer (0% vs. 65%, p=0.019) while more likely to have gallbladder cancer (75% vs. 22%, p=0.044) compared to the others. Age at diagnosis (66 vs 67 years, p=0.898), extrahepatic bile duct cancer incidence (25% vs. 13%, p=0.453) and survival status at last follow-up (50% vs. 42% alive, p=1.000) were comparable between the subgroups. Conclusion: The prevalence of PBM is substantially higher in adults with biliary malignancies than one would expect based on its incidence, reinforcing the etiologic role of PBM especially in females with gallbladder cancer.