followed with surveillance cross sectional imaging. In the surgery group, 59 (92%) had surgical resection of the extrahepatic bile duct with a cholecystectomy and Roux-En-Y hepaticojejunostomy. 4 (6.25%) patients had cholecystectomy for stone related symptoms. 1 (1.5%) had a Whipple. Thirty (48%) patients developed 49 postoperative complications. Twenty-six significant complications (Clavien-Dindo >3) were seen in 18 (28.5%) patients; 8 (26%) required PTC, 6 (16%) required ERCP, and 10 (30%) required an additional operation. There were no surgery related deaths. The average length of time with a PTC drain was 8.4 months (SD=10.2). The median length of follow up was 8.02 years (SD=3.47). Biliary malignancy was seen in 2 (2.5%) patients. One patient had an incidental diagnosis of T2 gallbladder cancer at age 55. One patient developed cholangiocarcinoma 12 years post-operatively at age 45. None of the resected patients had high grade dysplasia or invasive carcinoma present in excised cyst. Conclusion: The risk of developing cancer related to CC is low, especially in children and adolescents. Due to high surgery-associated morbidity and low cancer risk, it may be favorable to follow patients with imaging if they are asymptomatic.
The treatment of rectal cancer currently involves coordinated efforts for combined modality therapy with pre-operative chemoradiation followed by surgical management and additional adjuvant chemotherapy. The landscape of rectal cancer has shifted significantly over the past 30 years. This review aims to track this changing landscape, with a particular focus on current research and future endeavors.
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