Impact of prior cholecystectomy on diagnosis and outcomes of choledochal cyst resection in adults

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2024-11-14 DOI:10.1016/j.amjsurg.2024.116088

Aradhya Nigam , Grace C Bloomfield , Maryam Boumezrag , Salima Mansoor Ali , DongHyang Kwon , Reena C Jha , Thomas M Fishbein , Pejman Radkani , Emily R Winslow

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引用次数: 0

Abstract

Introduction

The diagnosis of choledochal cysts in the adult population is complicated by the expected physiologic dilation of the common bile duct after cholecystectomy. We aimed to compare patients who underwent choledochal cyst resection based on cholecystectomy status.

Methods

A retrospective analysis was conducted of patients who underwent choledochal cyst resection between 1/1/1998-12/31/2021. Patients were categorized based on whether they had undergone cholecystectomy prior to choledochal cyst diagnosis. Preoperative imaging characteristics, pathology findings, and outcomes were evaluated.

Results

Amongst 119 patients who underwent excision, 58 (46 %) had and 69 (54 %) had not undergone prior cholecystectomy. Preoperative imaging demonstrated no difference in biliary tract diameter although a greater proportion of patients with a gallbladder in place had an anomalous pancreaticobiliary junction (55 % v 33 %, p < 0.05). Biliary malignancy was observed in a greater proportion of patients with prior cholecystectomy although this was not statistically significant (5 % v 3 %; p = 0.9). Rates of post-operative complications were statistically similar between patient cohorts.

Discussion

Radiographic and clinical features were similar among patients who had and had not undergone cholecystectomy. Choledochal cyst patients should be managed uniformly regardless of cholecystectomy status.

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既往胆囊切除术对成人胆总管囊肿切除术诊断和结果的影响。

导言：由于胆囊切除术后胆总管会出现生理性扩张，因此成人胆总管囊肿的诊断非常复杂。我们的目的是根据胆囊切除术的情况对接受胆总管囊肿切除术的患者进行比较：我们对 1998 年 1 月 1 日至 2021 年 1 月 31 日期间接受胆总管囊肿切除术的患者进行了回顾性分析。根据患者在确诊胆总管囊肿之前是否接受过胆囊切除术进行分类。对术前影像学特征、病理结果和预后进行了评估：在接受切除术的 119 名患者中，58 人（46%）曾接受过胆囊切除术，69 人（54%）未接受过胆囊切除术。术前造影显示胆道直径没有差异，但有胆囊的患者胰胆管交界处异常的比例更高（55% 对 33%，P 讨论）：接受和未接受胆囊切除术的患者的放射学和临床特征相似。无论胆囊切除情况如何，胆总管囊肿患者都应得到统一的治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.