Choledochal cysts: Management and long-term follow-up. Issue 4 (August 2021)
- Record Type:
- Journal Article
- Title:
- Choledochal cysts: Management and long-term follow-up. Issue 4 (August 2021)
- Main Title:
- Choledochal cysts: Management and long-term follow-up
- Authors:
- Serin, Kursat Rahmi
Ercan, Leman Damla
Ibis, Cem
Ozden, Ilgin
Tekant, Yaman - Abstract:
- Abstract: Background: Choledochal cysts are congenital anomalies that can occur at any level of the biliary tree. They carry long-term risk of biliary complications and cancer development. Complete excision of all involved bile ducts is recommended. Methods: Patients treated between 1995 and 2019 were reviewed retrospectively. Results: Sixty patients; 46 female and 14 male with a median age of 41 years (range 13–83) were included in the study. Mild abdominal pain was the most common presenting symptom (60%). Majority of the patients had Todani type I cysts (67%). Concomitant biliary malignancy was diagnosed in five patients (9%). Eight patients were followed-up conservatively (13%). Twenty-five patients were treated by excision of the extrahepatic bile ducts and Roux-en-Y hepaticojejunostomy, liver resection was added in seven, pancreatoduodenectomy was done in three and liver transplantation in one. There was no perioperative mortality. Postoperative complications developed in 17 patients (34%), two requiring surgical treatment. Four of the five patients with malignancies died at a median 42 months (range 6–95) following surgery. Median 62 months (range 8–280) follow-up was available in 45 surgically treated patients, 19 followed-up for more than 10 years. None of the patients developed malignancy during follow-up. Four patients (17%) were readmitted for anastomotic strictures requiring treatment. Conclusion: The majority of choledochal cysts are Todani type-I and earlyAbstract: Background: Choledochal cysts are congenital anomalies that can occur at any level of the biliary tree. They carry long-term risk of biliary complications and cancer development. Complete excision of all involved bile ducts is recommended. Methods: Patients treated between 1995 and 2019 were reviewed retrospectively. Results: Sixty patients; 46 female and 14 male with a median age of 41 years (range 13–83) were included in the study. Mild abdominal pain was the most common presenting symptom (60%). Majority of the patients had Todani type I cysts (67%). Concomitant biliary malignancy was diagnosed in five patients (9%). Eight patients were followed-up conservatively (13%). Twenty-five patients were treated by excision of the extrahepatic bile ducts and Roux-en-Y hepaticojejunostomy, liver resection was added in seven, pancreatoduodenectomy was done in three and liver transplantation in one. There was no perioperative mortality. Postoperative complications developed in 17 patients (34%), two requiring surgical treatment. Four of the five patients with malignancies died at a median 42 months (range 6–95) following surgery. Median 62 months (range 8–280) follow-up was available in 45 surgically treated patients, 19 followed-up for more than 10 years. None of the patients developed malignancy during follow-up. Four patients (17%) were readmitted for anastomotic strictures requiring treatment. Conclusion: The majority of choledochal cysts are Todani type-I and early cyst excision is the mainstay of management, which may decrease the risk of malignant transformation. Highlights: Surgery for choledochal cysts is recommended because of the cholangiocarcinoma risk. Surgery is controversial for patients with intrahepatic extension. A wide range of surgical treatment from CBD resection to LTx may be required. Asymp patients who diagnosed elderly needs clarified whether treatment is needed. … (more)
- Is Part Of:
- Surgeon. Volume 19:Issue 4(2021)
- Journal:
- Surgeon
- Issue:
- Volume 19:Issue 4(2021)
- Issue Display:
- Volume 19, Issue 4 (2021)
- Year:
- 2021
- Volume:
- 19
- Issue:
- 4
- Issue Sort Value:
- 2021-0019-0004-0000
- Page Start:
- 200
- Page End:
- 206
- Publication Date:
- 2021-08
- Subjects:
- Cholangiocarcinoma -- Liver resection -- Hepatectomy -- Cholangitis
Surgery -- Periodicals
Surgery -- Periodicals
Surgical Procedures, Operative -- Periodicals
617 - Journal URLs:
- http://bibpurl.oclc.org/web/5397 ↗
http://www.elsevier.com/wps/find/journaldescription.cws_home/721359/description#description ↗
http://www.rcsed.ac.uk/journal/ ↗
http://www.sciencedirect.com/science/journal/1479666X ↗
http://www.thesurgeon.net/ ↗
http://www.elsevier.com/journals ↗ - DOI:
- 10.1016/j.surge.2020.06.013 ↗
- Languages:
- English
- ISSNs:
- 1479-666X
- Deposit Type:
- Legaldeposit
- View Content:
- Available online (eLD content is only available in our Reading Rooms) ↗
- Physical Locations:
- British Library DSC - 8548.120500
British Library DSC - BLDSS-3PM
British Library STI - ELD Digital store - Ingest File:
- 17457.xml