Long-term outcomes after extrahepatic excision of congenital choladocal cysts: 30 years of experience at a single center.

Hepato-gastroenterology Pub Date : 2015-01-01
Hideo Ohtsuka, Koji Fukase, Hiroshi Yoshida, Fuyuhiko Motoi, Hiroki Hayashi, Takanori Morikawa, Takaho Okada, Kei Nakagawa, Takeshi Naitoh, Yu Katayose, Michiaki Unno
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引用次数: 0

Abstract

Background/aims: Congenital choladocal cysts are generally treated by resection of the dilated extrahepatic biliary duct followed by hepaticojejunostomy, but it is associated with postoperative complications, including postoperative cholangitis, intrahepatic calculi, pancreatitis, and carcinogenesis, in the remnant bile duct. We investigated the most common long-term complications and identified the factors implicated in their development.

Methodology: We conducted a retrospective review and analysis of the long-term complications of 65 patients surgically treated for congenital choledochal cysts between 1978 and 2008 at one institute. The risk factors for intrahepatic calculi were identified based on the odds ratios of the implicated variables.

Results: Cholangitis with high fever or abdominal pain was reported in 14 patients (21.5%), intrahepatic calculi in 12 (18.5%), pancreatitis in 3 (4.6%), and cholangiocarcinoma in 3 (4.6%). Diagnosis with type IVa choledochal cysts was the most significant risk factor, followed by age ≥30 years at the time of treatment, and the presence of preoperative intrahepatic calculi.

Conclusions: While precise and thorough surgical treatment is necessary to prevent the long-term development of complications after surgical excision of congenital choledochal cysts, it must be accompanied by long-term postoperative follow-up, especially of elderly patients and those with type IVa cysts.

先天性胆总管囊肿肝外切除后的长期预后:单一中心30年的经验。
背景/目的:先天性胆总管囊肿的治疗方法通常是切除扩张的肝外胆管,然后进行肝空肠吻合术,但它与术后并发症有关,包括残余胆管的术后胆管炎、肝内结石、胰腺炎和癌变。我们调查了最常见的长期并发症,并确定了影响其发展的因素。方法:回顾性分析某研究所1978年至2008年间65例先天性胆总管囊肿手术治疗的远期并发症。根据相关变量的比值比确定肝内结石的危险因素。结果:胆管炎伴高热或腹痛14例(21.5%),肝内结石12例(18.5%),胰腺炎3例(4.6%),胆管癌3例(4.6%)。诊断为IVa型胆总管囊肿是最重要的危险因素,其次是治疗时年龄≥30岁和术前是否存在肝内结石。结论:精确、彻底的手术治疗是预防先天性胆总管囊肿手术切除后并发症长期发展的必要条件,但必须配合术后长期随访,尤其是老年患者和IVa型囊肿患者。
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来源期刊
Hepato-gastroenterology
Hepato-gastroenterology 医学-外科
自引率
0.00%
发文量
1
审稿时长
1.9 months
期刊介绍: Hepato-Gastroenterology has been discontinued as of 2015. Extremely limited quantities of back issues in print available for sale.
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