Bile duct cancer developed after cyst excision for choledochal cyst.
Bile duct cancer developed after cyst excision for choledochal cyst.
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DOI：
10.1007/s005340050108
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发表时间：
1999-01-01
期刊：
影响因子：
--
通讯作者：
Todani, T
中科院分区：
文献类型：
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作者：
Watanabe, Y;Toki, A;Todani, T
本文讨论胆总管囊肿切除术后之肿瘤发生及适合之手术方式。回顾了英文和日本文献中报道的23例胆总管囊肿切除术后发生胆管癌的患者的临床资料，并分析了1353例日本胆总管囊肿和/或胰胆管畸形愈合患者的数据。在文献中报告的23例患者中，囊肿切除时的年龄范围为1 - 55岁（平均23.0 ± 13.7岁），在18-60岁（平均32.1 ± 12.2岁）时检测到癌症，囊肿切除和癌症检测之间的间隔为1-19年（平均9.0 ± 5.5年）。癌发生部位：肝内6例，吻合口8例，肝侧残留囊肿3例，胰管内6例。在胆总管囊肿和/或胰胆管畸形愈合的日本患者中，与原发性胆总管囊肿和/或胰胆管畸形愈合相关的癌症发生率为16.2%（219/1353）。该人群（其中1291/1353人接受了手术）囊肿切除后癌症发展的发生率假设为0。百分之七在文献中的23例患者中，近一半的患者接受了不充分的囊肿切除。囊肿切除后的肿瘤发生可能与胆总管囊肿不同。
Oncogenesis after cyst excision for choledochal cyst and suitable surgical procedures for this operation are discussed. The clinical data of 23 patients with cancer of the biliary tree after excision of choledochal cyst reported in the English-language and Japanese literature were reviewed, and data for 1353 Japanese patients with choledochal cyst and/or pancreaticobiliary malunion were analyzed. In the 23 patients reported in the literature, age at cyst excision ranged from 1 to 55 years (average, 23.0 +/- 13.7 years), and cancers were detected at age 18-60 years (average, 32.1 +/- 12.2 years), with intervals between cyst excision and cancer detection of 1-19 years (average, 9.0 +/- 5.5 years). Sites of cancer development were: intrahepatic, six; anastomotic, eight; hepatic side residual cyst, three; and the intrapancreatic duct, six. In the Japanese patients with choledochal cyst and/or pancreaticobiliary malunion, the incidence of cancer associated with primary choledochal cyst and/or pancreaticobiliary malunion was 16.2% (219/1353). The incidence of cancer development after cyst excision in this population, of whom 1291/1353 underwent surgery, was assumed to be 0. 7%. Nearly half of the 23 patients in the literature had undergone inadequate cyst excision. Oncogenesis of cancers after cyst excision is possibly different from that of choledochal cysts.