Review Article

Pancreaticobiliary Maljunction Is Associated with Common Bile Duct Carcinoma: A Meta-Analysis

Table 1

Characteristics of 10 studies included in this meta-analysis.

First author (year)Country of originStudy periodNo. of casesNo. of controlsDiagnosis of PBMAdjusted OR95% CI

Case-control studies
 Kamisawa et al. [13] (2010)Japan1973–2009107 cases;
Asian
159 patients without CBDC;
Asian
ERCP or PTC
Common channel >15 mm in length and a lack of effect of the sphincter of Oddi at the union of the pancreatic and biliary ducts
1.160.49–2.75

 Matsumoto et al. [18] (2003)Japan1983–2003250 cases;
Asian
2839 cases without CBDC;
Asian
ERCP
Common channel ≥10 mm in length or <10 mm and a lack of contraction of the Oddi at the union of the pancreatic and biliary ducts
1.310.86–1.98

 Wang et al. [23] (1998)Taiwan1992–199627 cases;
Asian
653 cases;
Asian
ERCP
Common channel ≥12 mm in length and/or one duct joining perpendicularly to another
3.761.05–13.48

 Roukounakis et al. [10] (2007)USA1989–199826 cases;
Caucasian
154 cases with normal films or nonmalignant pancreaticobiliary diseases for the same period;
Caucasian
Cholangiopancreatogram and ERCP
Common channel ≥8 mm in length or/and one duct joining perpendicularly to another
3.320.92–11.95

 Ohuchida et al. [24] (2006)Japan1979–2004196 cases;
Asian
157 benign biliary diseases cases;
Asian
ERCP and/or MRCP
Common channel ≥15 mm in length on cholangiopancreatogram and a high level of amylase in bile
1.220.53–2.79

 Song et al. [25] (1999)Korea1990–1996329 cases;
Asian
5037 cases underwent ERCP with benign biliary disease;
Asian
ERCP
The anomalous union of pancreaticobiliary duct system at a distance >15 mm from the papilla of Vater
2.091.26–3.46

 Suda et al. [26] (1983)Japan1978–198372 cases;
Asian
171 cases randomly selected and autopsied;
Asian
Surgery0.980.47–2.05

 Seki et al. [27] (2005)Japan1988–200338 cases;
Asian
145 cases without CBDC;
Asian
ERCP or MRCP
Common channel ≥10 mm and an anomalous junction of the pancreatic and biliary ducts located outside the duodenal wall
0.990.37–2.65

Cohort studies
 Tashiro et al. [8] (2003)Japan1990–1999680 cases from the 141 hospitals throughout the country;
Asian
2667 cases without biliary tract carcinoma;
Asian
ERCP or PTC
Common channel ≥15 mm in length and the junction located outside duodenal wall
1.981.06–3.71

 Hasumi et al. [16] (2000)Japan1980–1984414 cases from 133 institutions;
Asian
11,985 benign biliary cases underwent hepatobiliary tract surgery at the same 133 institutions;
Asian
ERCP or PTC
Common channel ≥15 mm in length and union free of effect of sphincter
1.390.97–2.00

PBM: pancreaticobiliary maljunction; CBDC: common bile duct carcinoma; CDC: congenital dilatation of the common bile duct; ERCP: endoscopic retrograde cholangiopancreatography; MRCP: magnetic resonance cholangiopancreatography; PTC: percutaneous transhepatic cholangiography.