Primary carcinoma of the gallbladder associated with anomalous pancreaticobiliary ductal junction.

Anomalous pancreaticobiliary ductal junction (APBDJ) is a rare anomaly but is a risk factor for primary carcinoma of the gallbladder. To define the relationship between APBDJ and gallbladder carcinoma, we retrospectively reviewed data of 57 patients with gallbladder carcinoma. Of these patients, 25 had undergone endoscopic retrograde cholangiopancreaticography (ERCP) and four (16%) exhibited APBDJ. The age of those patients with APBDJ was 58.0 +/- 8.6 years and that of the patients without APBDJ was 59.2 +/- 3.1 years. Two (50.0%) of the APBDJ patients had gallstones and 47.6% of the patients without APBDJ had gallstones. The mean length of the common channel was 30 mm (range 22-38). The mode of ductal junction was three pancreatic-biliary types and one biliary-pancreatic type. One patient had an associated choledochal cyst. All the four patients with APBDJ had advanced gallbladder cancers. Consideration of gallbladder carcinoma in the patients with APBDJ may improve early detection and their survival rate.