Canceration of congenital choledochal cyst:reports of 16 cases
- VernacularTitle:先天性胆总管囊肿癌变的防治经验
- Author:
Liubin SHI
;
Shuyou PENG
;
Chenghong PENG
- Publication Type:Journal Article
- Keywords:
Choledochal cyst;
Surgical procedures,operative
- From:
Chinese Journal of General Surgery
1997;0(04):-
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo summarize the experience in diagnosis and treatment of malignant change in choledochal cyst patients in the past 20 years. MethodsThe clinical data of 16 patients admitted from 1980 to 2000 were analyzed retrospectively. Results9 patients had had a previous internal drainage procedure,12 patients had biliary tract infection, 4 cases presented with abdominal masses. All suffered body weight loss and general malaise. ERCP was performed in 5 cases with no previous operation, in which abnormal pancreatobiliary duct junction was found in 4 patients. Laparotomy plus metastatic lymph node biopsy was performed in 4 patients, choledochotomy with T-tube drainage for 4 patients, cyst excision and pancreatoduodenectomy for 3 cases, partial cyst excision with left lobectomy for 2 patients, cyst excision with Roux-en-Y hepaticojejunostomy for 3 patients. Pathology proved carcinoma was located in cyst wall in most cases.Postoperative survival time ranged from 4 to 31 months with a mean of 12.7 months. ConclusionsThe clinical symptoms of malignant change in congenital choledochal cyst were non-specific. The preoperative diagnosis for canceration was difficult, and the prognosis was poor.Total extrahepatic choledochocele resection should be adopted for the prevention of canceration.Intraoperative frozen section is helpful to confirm diagnosis. Cyst excision with pancreatoduodenectomy is the treatment of choice for carcinoma invading pancreatic head.
