Biliary carcinomas arising in patients who have undergone bilioenterostomy is a clinical concern. Thus, we investigated if bilioenterostomy influences biliary carcinogenesis in hamsters. Syrian hamsters were divided into three groups according to the operative procedure: simple laparotomy (SL), choledochoduodenostomy (CD), and choledochojejunostomy (CJ). The animals were given no chemical carcinogens during the experiments and five to six hamsters in each group were killed every 20 weeks for up to 120 weeks after surgery. There were 37, 32, and 38 hamsters in the SL, CD, and CJ groups, respectively. Cholangiocarcinomas developed in 5.4%, 15.6%, and 23.7% of hamsters in the SL group, the CD group, and the CJ group, respectively. The incidence of biliary carcinoma was significantly higher in the bilioenterostomy groups, especially the CJ group (P < 0.05), than in the SL group. Tumor latency periods after surgery were 20 to 40 weeks shorter in the bilioenterostomy groups than in the SL group. Persistent cholangitis and bile stasis were observed in the bilioenterostomy groups, and there was a significant correlation between cholangitis and biliary carcinogenesis in the CD group. The proliferative cell nuclear antigen (PCNA) labeling index of the biliary epithelium was elevated in the bilioenterostomy groups. Thus, we conclude that persistent cholangitis after bilioenterostomy accelerates biliary carcinogenesis by activating the biliary epithelial cell kinetics.
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Kitajima, T., Matsuzaki, S., Kuroki, T., Fukuda, K., Tajima, Y., Kanematsu, T. (2009). Spontaneous Biliary Carcinogenesis. In: Tajima, Y., Kuroki, T., Kanematsu, T. (eds) Hepatobiliary and Pancreatic Carcinogenesis in the Hamster. Springer, Tokyo. https://doi.org/10.1007/978-4-431-87773-8_8
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