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KMID : 0371420211010060332
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Annals of Surgical Treatment and Research
2021 Volume.101 No. 6 p.332 ~ p.339
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Clinical characteristics of patients with malignancy and long-term outcomes of surgical treatment of patients with choledochal cyst
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Han Wung-Sun
Kim Hong-Beom
Sohn Hee-Ju
Lee Mi-Rang
Kang Yoon-Hyung
Kim Hyeong-Seok
Han Young-Min
Kang Jae-Seung
Kwon Woo-Il
Jang Jin-Young
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Abstract
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Purpose: There are few reports of postoperative long-term malignant risk or postoperative sequelae after surgery for choledochal cysts (CCs). This study aimed to analyze the clinical characteristics of patients with malignancy and the long-term results of operated CC.
Methods: The patients who underwent surgical treatments for CC between 2003 and 2020 at Seoul National University Hospital were enrolled. Clinicopathologic factors and pre-/postoperative computed tomography or magnetic resonance imaging were reviewed.
Results: Of the 153 patients, Todani classification Ic (36.6%), C-P type (43.8%) anomalous pancreaticobiliary duct union were the most common type respectively. Fourteen patients (9.2%) had biliary tract cancer and a comparison of patients with and without malignancy showed that the diameter of cyst was significantly lower in malignant patients and malignancy was observed to be significantly higher in P-C type. The incidence of long-term complications was 9.8%, and the median time interval was 30 months. The 2 most common complications were cholangitis and stricture (60.0%). There was one case of new cancer near the intrapancreatic remnant bile duct.
Conclusion: Of the resected CCs, 9.2% had a combined malignancy on the biliary tracts. Long-term complications such as cholangitis, anastomotic stricture, and new cancers may occur. Therefore, continuous surveillance is required.
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KEYWORD
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Biliary tract, Choledochal cyst, Neoplasms
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