Malignant change in the biliary tract after excision of choledochal cyst

Ishibashi, T; Kasahara, Kogoro; Yasuda, Yoshikazu; Nagai, Hirokazu; Makino, Shin-ichi; Kanazawa, Kyotaro

doi:10.1046/j.1365-2168.1997.02843.x

Cited by 63 publications

(64 citation statements)

References 18 publications

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“…The cancer may arise either in the cyst wall itself 8 , or in remnant tissue or undilated parts of the extrahepatic or intrahepatic bile duct 61 . The presence of an APBDJ increases the potential for malignant change in both the gallbladder and bile duct 25,28,30,31,59 . Reflux of pancreatic enzymes, amylase, bile stasis, and an increased intraductal concentration of bile acids contribute to the proliferative activity of bile acids in patients with choledochal cysts 62 -64 .…”

Section: Malignancymentioning

confidence: 99%

Bile duct cysts in adults

Søreide

Kørner

Havnen

et al. 2004

British Journal of Surgery

179

191

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An increasing rate of occurrence of bile duct cyst is reported in adults. Type IV cysts are more frequent in adults than children. Presentation tends to be non-specific abdominal discomfort. Related hepatobiliary or pancreatic disease frequently precedes recognition, and may complicate the postoperative course. Surgical treatment aims to relieve complications deriving from the cysts and to reduce the significant risk of malignant change within the biliary tree. Complete cyst resection, cholecystectomy and Roux-en-Y hepaticojejunostomy reconstruction is standard. Controversy exists about the role of hepatic resection in type IV and V cysts, and the role of minimally invasive and laparoscopic treatment. In general, the outcome is good and a near-zero mortality rate has been reported in institutional series over the past decade.

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Section: Malignancymentioning

confidence: 99%

Bile duct cysts in adults

Søreide

Kørner

Havnen

et al. 2004

British Journal of Surgery

179

191

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“…This result is very low when compared to the literature and the Todani classification, in which 80-90% of cases represent this type (Lipsett et al 1997). In fact, 60-80% of adults with choledochal cysts had complications like stone formation and cystic wall carcinoma, especially type one choledochal cyst showed a higher cancer incidence (Ishibashi et al 1997). In the clinical practice, wide (ERCP) utilization recognized increasingly the anatomic abnormalities of biliary system entry into the upper gastrointestinal tract.…”

Section: Discussionmentioning

confidence: 99%

Anatomical variations of the hepatobiliary system in Sudanese patients undergoing endoscopic retrograde cholangiopancreatography (ERCP)

Doush¹,

A-Galil

Ibrahim

2017

IJM

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Background: The meticulous identification of the hepatobiliary tree system normal anatomy during surgical operations is crucial in iatrogenic injury prevention. Equally important, an understanding of the congenital variations of biliary and vascular anatomy, as the literature abounds with reports of specific anatomical variations, and their surgical implications. Aim: This study aimed to study the presence of anatomical variations within the hepatobiliary system in Sudanese population undergoing endoscopic retrograde cholangiopancreatography (ERCP). Patients and methods:The records of patients undergoing ERCP in Soba University Hospital during 2004 to 2008 were analyzed. There were 277 Sudanese patients who had complained of right hypochondrial abdominal pain & history of jaundice (obstructive jaundice) that underwent ERCP were included within this study. The exclusion criteria included the following: Sudanese patients in whom ERCP failed or patients who had advanced hepatobiliary disease like cancers, strictures either cancerous or iatrogenic, fistula and iatrogenic biliary leak. Results: The analysis of 277 Sudanese patients undergoing ERCP of the hepatobiliary system showed the following results regarding the variations: The choledochal cyst type one (fusiform type) was present in 3 (1.08%) patients; very low cystic duct insertion (parallel) was present in 1 (0.36%) patient and long cystic duct was present in 3 (1.08%) patients. The ampulla of Vater size variations occurred as A) Normal in 158 (57%) patient, B) Small in 56 (20.2%) patients, C) Large in 29 (10.5%) patients, D) Periampullary diverticula in 4 (1.4%) patients and E) unclassified in 30 (10.8%) patients. Other forms of congenital anomalies were not found. Conclusion: The using of endoscopic retrograde cholangiopancreatography (ERCP) is a reliable radiological method for depicting congenital anomalies of the hepatobiliary system, but it is an invasive procedure.

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“…Once PBM is diagnosed, the development of cancer should be prevented by removal of the entire extrahepatic bile duct, even in patients without biliary dilation [3] . However, it has been reported that residual bile duct cancer could be found during the long-term follow-up period, even after termination of pancreatic enzyme reflux [4][5][6] , and Watanabe et al [6] reported that 23 (0.7%) of 1291 patients developed residual bile duct cancer after cyst excision. Besides residual bile duct cancer, other periampullary carcinomas have been reported, but they are very rare [7,8] .…”

Section: Introductionmentioning

confidence: 99%

Carcinoma of the papilla of Vater following treatment ofpancreaticobiliary maljunction

Watanabe¹,

Midorikawa²,

Yamano³

et al. 2009

WJG

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Pancreaticobiliary maljunction (PBM) is frequently associated with biliary cancer due to reflux of pancreatic enzymes into the choledochus, and even after surgery to correct the PBM such patients still have a risk of residual bile duct cancer. Here, we report the case of a 59-year-old female with carcinoma of the papilla of Vater which developed 2.5 years after choledochoduodenostomy for PBM. During the postoperative follow-up period, computed tomography obtained 2 years after the first operation demonstrated a tumor in the distal end of the choledochus, although she did not have jaundice and laboratory tests showed no abnormalities caused by the previous operation. As a result, carcinoma of the papilla of Vater was diagnosed at an early stage, followed by surgical cure. For early detection of periampullary cancer in patients undergoing surgery for PBM, careful long-term followup is needed.

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Malignant change in the biliary tract after excision of choledochal cyst

Abstract: Malignant change has not been observed after total or subtotal excision of choledochal cysts in this series.

Cited by 63 publications

References 18 publications

Bile duct cysts in adults

Bile duct cysts in adults

Anatomical variations of the hepatobiliary system in Sudanese patients undergoing endoscopic retrograde cholangiopancreatography (ERCP)

Carcinoma of the papilla of Vater following treatment ofpancreaticobiliary maljunction

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