Malignant change in the biliary tract after excision of choledochal cyst
Malignant change in the biliary tract after excision of choledochal cyst
复制标题
DOI：
10.1002/bjs.1800841212
复制
发表时间：
1997-12-01
影响因子：
9.6
通讯作者：
Kanazawa, K
中科院分区：
文献类型：
--
作者：
Ishibashi, T;Kasahara, K;Kanazawa, K
胆总管囊肿是一种罕见的先天性疾病，如果不及时治疗，其恶性变化的风险很高。胆总管囊肿手术切除后发生恶性肿瘤的风险尚不清楚。方法对我院21年来收治的48例胆总管囊肿患者进行回顾性分析，探讨囊肿切除术后发生恶性变化的风险。48例患者中39例首次入院时无癌；平均（sd）年龄为20（18）岁。39例患者中37例行囊肿切除和胆囊切除术后肝肠吻合术。结果37例患者中28例囊肿切除不完全，因为胆管扩张部分仍在近端和/或远端。在这37例患者中，平均（s.d.）随访9.1年（6.4年）后，残余的近端肝管或末端胆管未发生癌。其余9例患者在第一次就诊时被诊断为胆道癌。6例患者因复发死亡，平均生存时间为13（11）个月，3例患者术后2个月、1年和7年存活且无复发。结论本组病例全部或次全切除胆总管囊肿均未见恶性改变。
Background Choledochal cyst is a rare congenital condition with a high risk of malignant change if untreated. The risk of malignancy after surgical excision of choledochal cyst is not known.Methods Forty-eight patients with choledochal cysts managed over a 21-year period were reviewed, to determine the risk of malignant change after cyst excision. Thirty-nine of 48 patients had no carcinoma at first admission; their mean(s.d.) age was 20(18) years. Thirty-seven of 39 patients underwent cyst excision and cholecystectomy followed by hepaticoenterostomy.Results Cyst excision was incomplete in 28 of the 37 patients because dilated portions of the biliary ducts remained proximally and/or distally. In these 37 patients, no carcinoma has developed in the remnant proximal hepatic duct or the terminal bile duct after mean(s.d.) follow-up of 9.1(6.4)years. In the remaining nine patients, biliary carcinoma was diagnosed at the first visit. Six patients died from recurrence with a mean(s.d.) survival time of 13(11) months, while three patients were alive and free from recurrence 2 months, 1 year and 7 years after operation.Conclusion Malignant change has not been observed after total or subtotal excision of choledochal cysts in this series.