Pancreaticobiliary Maljunction and Congenital Biliary Dilatation by Terumi Kamisawa & Hisami Ando

Author:Terumi Kamisawa & Hisami Ando
Language: eng
Format: epub
Publisher: Springer Singapore, Singapore

17.1.2 Bile Amylase Level

Although the amylase level in BJ of within the normal upper limit of serum amylase level has been considered as “normal” in the several previous reports [8–10], there is no conclusive evidence of this. Large-scale retrospective studies in Japan and Europe have reported BJ amylase levels in PBM over 50,000 IU/L [1, 11], and others reported values over 10,000 IU/L [4, 6, 9, 12, 13] (Table 17.1). However, some patients with PBM have normal bile amylase levels, possibly because of the disruption of exocrine pancreatic function due to pancreatitis [1, 5]. BJ amylase level in the gallbladder is considered to be higher than that in the bile duct because of the condensing function of the gallbladder [1, 7]. Others have showed that biliary amylase level in the bile duct was higher than that in the gallbladder [4, 12]. Furthermore, according to one nationwide survey in Japan, BJ amylase in PBM without biliary dilatation is significantly higher than that with biliary dilatation [15]. However, in the gallbladder with PBM, the BJ amylase level is significantly higher with biliary dilatation than that without dilatation. Furthermore the BJ amylase level in the common bile duct in PBM with biliary dilatation is the same as that without dilatation [1]. Adult patients with PBM have significantly higher amylase levels in the biliary tract (common bile duct or gallbladder) than children with PBM, irrespective of the presence or absence of biliary dilatation [1].Table 17.1Gallbladder or bile duct amylase levels in patients with pancreaticobiliary maljunction

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