Pancreaticobiliary Reflux in Patients Without Cholelithiasis

Completed

Interventions: Procedure: Gallbladder bile sampling and intraoperative cholangiography

Brief Summary: Pancreaticobiliary reflux has been found in patients with cholelithiasis and gallbladder cancer associated with normal pancreaticobiliary union. However, the presence of pancreaticobiliary reflux has not been studied in patients without gallstones (healthy gallbladders).

The authors believe that pancreaticobiliary reflux might be a normal phenomenon in patients with and without gallstones, although in patients with cholelithiasis it might constitute a pathological condition associated with dismotility of the biliary tree and the sphincter of Oddi.

Detailed Description: The objective of this study is to measure the levels of amylase and lipase in gallbladder bile of patients without gallstones and compare these values to the values of amylase and lipase of patients with gallstones and normal pancreaticobiliary union evidenced by intraoperative cholangiography.

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

Common bile duct stones
Anatomic anomalies at the pancreaticobiliary junction evidenced by intraoperative cholangiography
Altered preoperative amylase and lipase levels
Altered preoperative hepatic function tests
Emergency surgery

Arm && Interventions

Group	Intervention	Description
Normal Gallbladder	Gallbladder bile sampling and intraoperative cholangiography	Patients with normal gallbladder (without gallstones) evidenced by preoperative ultrasonography (and postoperative biopsy) submitted to elective gastroesophageal surgery (gastrectomy for gastric cancer, bariatric surgery or esophageal surgery such as Nissen plicature or miotomy for achalasia). The pancreaticobiliary junction must be normal as evidenced by intraoperative cholangiography. Preoperative values of amylase and lipase must be normal.
Gallbladder with gallstones	Gallbladder bile sampling and intraoperative cholangiography	Patients submitted to elective cholecystectomy for diseased gallbladders (gallbladder with gallstones evidenced by preoperative ultrasound). The pancreaticobiliary junction must be normal as evidenced by intraoperative cholangiography and the preoperative amylase and lipase levels must also be normal.

Primary Outcome Measures

Name	Time	Method
Amylase and Lipase Values in Gallbladder Bile	24 hours	Normal values of lipase and amylase in gallbladder bile should be zero

Secondary Outcome Measures

Name	Time	Method
Amylase and Lipase Values in Normal Gallbladders	24 hours
Amylase and Lipase Values in Gallbladders With Cholelithiasis	24 hours
Normal Operative Cholangiography	24 hours
Normal Preoperative Serum Values of Amylase and Lipase	24 hours