Risk of subsequent biliary malignancy in patients undergoing cyst excision for congenital choledochal cysts.
Risk of subsequent biliary malignancy in patients undergoing cyst excision for congenital choledochal cysts.
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DOI：
10.1111/j.1440-1746.2012.07260.x
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发表时间：
2013-02
影响因子：
4.1
通讯作者：
Ajioka Y
中科院分区：
文献类型：
--
作者：
Ohashi T;Wakai T;Kubota M;Matsuda Y;Arai Y;Ohyama T;Nakaya K;Okuyama N;Sakata J;Shirai Y;Ajioka Y
本研究的目的是阐明先天性胆总管囊肿行囊肿切除术的患者随后发生胆道恶性肿瘤的风险。回顾性分析94例先天性胆总管囊肿行囊肿切除术的病例。囊肿切除时的中位年龄和囊肿切除后的中位随访时间分别为7岁和181个月。在囊肿切除术后13年、15年、23年和32年，4例患者发生胆道癌。囊肿切除后15年、20年和25年胆道癌的累积发病率分别为1.6%、3.9%和11.3%。胆管癌的部位为肝内胆管（n = 2）、肝门胆管（n = 1）和胰腺内胆管（n = 1）。在4例囊肿切除后的胆道癌患者中，3例接受手术切除，1例接受放化疗。4例胆道癌患者治疗后的总累积生存率为2年50%，3年25%，中位生存时间为15个月。先天性胆总管囊肿行囊肿切除术的患者，远期发生胆道恶性肿瘤的风险似乎相对较高。囊肿切除术后15年以上，残余胆管中胆道恶性肿瘤的风险增加。尽管对这种情况采取了积极的治疗方法，但先天性胆总管囊肿切除术后继发的胆道恶性肿瘤显示了不利的结局。
The aim of this study was to elucidate the risk of subsequent biliary malignancy in patients undergoing cyst excision for congenital choledochal cysts. A retrospective analysis of 94 patients who had undergone cyst excision for congenital choledochal cysts was conducted. The median age at the time of cyst excision and median follow-up time after cyst excision were 7 years and 181 months, respectively. Biliary tract cancer developed in four patients at 13, 15, 23, and 32 years after cyst excision. The cumulative incidences of biliary tract cancer at 15, 20, and 25 years after cyst excision were 1.6%, 3.9%, and 11.3%, respectively. The sites of biliary tract cancer were the intrahepatic (n = 2), hilar (n = 1), and intrapancreatic (n = 1) bile ducts. Of the four patients with biliary tract cancer after cyst excision, three patients underwent surgical resection and one patient received chemo-radiotherapy. The overall cumulative survival rates after treatment in the four patients with biliary tract cancer were 50% at 2 years and 25% at 3 years, with a median survival time of 15 months. The risk of subsequent biliary malignancy in patients undergoing cyst excision for congenital choledochal cysts seems to be relatively high in the long-term. The risk of biliary malignancy in the remnant bile duct increases more than 15 years after cyst excision. Despite an aggressive treatment approach for this condition, subsequent biliary malignancy following cyst excision for congenital choledochal cysts shows an unfavorable outcome.
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DOI：
10.1007/s00534-009-0052-3
发表时间：
2009-09-01
期刊：
JOURNAL OF HEPATO-BILIARY-PANCREATIC SURGERY
影响因子：
--
作者：
Kawarada, Yoshifumi;Das, Bidhan C.;Isaji, Shuji
通讯作者：
Isaji, Shuji
影响因子：
3
作者：
TODANI, T;WATANABE, Y;OKAJIMA, K
通讯作者：
OKAJIMA, K
影响因子：
9
作者：
Takeshita, Nobuhiro;Ota, Takehiro;Yamamoto, Masakazu
通讯作者：
Yamamoto, Masakazu
影响因子：
9.6
作者：
Ishibashi, T;Kasahara, K;Kanazawa, K
通讯作者：
Kanazawa, K
影响因子：
2.4
作者：
Ono, Shigeru;Sakai, Kohei;Iwai, Naomi
通讯作者：
Iwai, Naomi