Risk factors and clinical characteristics of occult pancreaticobiliary reflux in benign gallbladder diseases

Abstract Background This study aimed to elucidate the clinical characteristics of occult pancreaticobiliary reflux (OPBR) in benign gallbladder diseases, including gallbladder stone (GS), gallbladder polyp (GP), and gallbladder adenomyomatosis (GA). Methods We studied 578 patients with a normal panc...

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Main Authors: Yukai Xiang, Chen Qiu, Hai Hu, Jingli Cai, Gang Zhao, Anhua Huang, Anan Xu, Chuanqi He, Cheng Zhang, Yulong Yang, Zhaoyan Jiang
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Gastroenterology
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Online Access:https://doi.org/10.1186/s12876-025-04131-3
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author Yukai Xiang
Chen Qiu
Hai Hu
Jingli Cai
Gang Zhao
Anhua Huang
Anan Xu
Chuanqi He
Cheng Zhang
Yulong Yang
Zhaoyan Jiang
author_facet Yukai Xiang
Chen Qiu
Hai Hu
Jingli Cai
Gang Zhao
Anhua Huang
Anan Xu
Chuanqi He
Cheng Zhang
Yulong Yang
Zhaoyan Jiang
author_sort Yukai Xiang
collection DOAJ
description Abstract Background This study aimed to elucidate the clinical characteristics of occult pancreaticobiliary reflux (OPBR) in benign gallbladder diseases, including gallbladder stone (GS), gallbladder polyp (GP), and gallbladder adenomyomatosis (GA). Methods We studied 578 patients with a normal pancreaticobiliary junction undergoing surgery for gallbladder diseases between December 2020 and January 2022. Of these, 80 patients had elevated bile amylase levels (> 110U/L) and were classified as OPBR patients; 498 comprised the control group. Patients fell into four groups: Group A (GA), Group B (GS alone), Group C (GS and GP), and Group D (GP alone). Results OPBR occurred in 16.2% of GS cases, 7.2% of GP cases, and 20.3% of GA cases. Patients with OPBR were typically older and more likely to have GS but less likely to have GP. In GS patients, OPBR incidence correlated with stone size, peaking at 48% in cases of gallbladder sludge (< 3 mm). OPBR incidence was highest in Group A (20.3%), followed by Group B (16.6%), Group C (8.9%), and Group D (4.8%). Patients over 50 and those in Groups A and B faced higher OPBR risk. In Group A, gallbladder sludge and hyper-gamma-glutamyltransferase were risk factors, while in Group B, gallbladder sludge and age over 50 were risk factors. No specific features associated with OPBR were found in Groups C and D. Conclusion In conclusion, GP isn’t associated with OPBR, irrespective of GS presence. However, in GS alone or GA patients, gallbladder sludge should raise OPBR concerns, necessitating tailored clinical attention.
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spelling doaj-art-347b65c9488043c7af61e2dc46acdecb2025-08-20T03:43:15ZengBMCBMC Gastroenterology1471-230X2025-07-0125111110.1186/s12876-025-04131-3Risk factors and clinical characteristics of occult pancreaticobiliary reflux in benign gallbladder diseasesYukai Xiang0Chen Qiu1Hai Hu2Jingli Cai3Gang Zhao4Anhua Huang5Anan Xu6Chuanqi He7Cheng Zhang8Yulong Yang9Zhaoyan Jiang10Center of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, School of Medicine, Tongji UniversityCenter of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, School of Medicine, Tongji UniversityCenter of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, School of Medicine, Tongji UniversityCenter of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, School of Medicine, Tongji UniversityCenter of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, School of Medicine, Tongji UniversityCenter of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, School of Medicine, Tongji UniversityCenter of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, School of Medicine, Tongji UniversityCenter of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, School of Medicine, Tongji UniversityCenter of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, School of Medicine, Tongji UniversityCenter of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, School of Medicine, Tongji UniversityCenter of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, School of Medicine, Tongji UniversityAbstract Background This study aimed to elucidate the clinical characteristics of occult pancreaticobiliary reflux (OPBR) in benign gallbladder diseases, including gallbladder stone (GS), gallbladder polyp (GP), and gallbladder adenomyomatosis (GA). Methods We studied 578 patients with a normal pancreaticobiliary junction undergoing surgery for gallbladder diseases between December 2020 and January 2022. Of these, 80 patients had elevated bile amylase levels (> 110U/L) and were classified as OPBR patients; 498 comprised the control group. Patients fell into four groups: Group A (GA), Group B (GS alone), Group C (GS and GP), and Group D (GP alone). Results OPBR occurred in 16.2% of GS cases, 7.2% of GP cases, and 20.3% of GA cases. Patients with OPBR were typically older and more likely to have GS but less likely to have GP. In GS patients, OPBR incidence correlated with stone size, peaking at 48% in cases of gallbladder sludge (< 3 mm). OPBR incidence was highest in Group A (20.3%), followed by Group B (16.6%), Group C (8.9%), and Group D (4.8%). Patients over 50 and those in Groups A and B faced higher OPBR risk. In Group A, gallbladder sludge and hyper-gamma-glutamyltransferase were risk factors, while in Group B, gallbladder sludge and age over 50 were risk factors. No specific features associated with OPBR were found in Groups C and D. Conclusion In conclusion, GP isn’t associated with OPBR, irrespective of GS presence. However, in GS alone or GA patients, gallbladder sludge should raise OPBR concerns, necessitating tailored clinical attention.https://doi.org/10.1186/s12876-025-04131-3Occult pancreaticobiliary refluxGallbladder stoneGallbladder polypGallbladder adenomyomatosisGallbladder sludge
spellingShingle Yukai Xiang
Chen Qiu
Hai Hu
Jingli Cai
Gang Zhao
Anhua Huang
Anan Xu
Chuanqi He
Cheng Zhang
Yulong Yang
Zhaoyan Jiang
Risk factors and clinical characteristics of occult pancreaticobiliary reflux in benign gallbladder diseases
BMC Gastroenterology
Occult pancreaticobiliary reflux
Gallbladder stone
Gallbladder polyp
Gallbladder adenomyomatosis
Gallbladder sludge
title Risk factors and clinical characteristics of occult pancreaticobiliary reflux in benign gallbladder diseases
title_full Risk factors and clinical characteristics of occult pancreaticobiliary reflux in benign gallbladder diseases
title_fullStr Risk factors and clinical characteristics of occult pancreaticobiliary reflux in benign gallbladder diseases
title_full_unstemmed Risk factors and clinical characteristics of occult pancreaticobiliary reflux in benign gallbladder diseases
title_short Risk factors and clinical characteristics of occult pancreaticobiliary reflux in benign gallbladder diseases
title_sort risk factors and clinical characteristics of occult pancreaticobiliary reflux in benign gallbladder diseases
topic Occult pancreaticobiliary reflux
Gallbladder stone
Gallbladder polyp
Gallbladder adenomyomatosis
Gallbladder sludge
url https://doi.org/10.1186/s12876-025-04131-3
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