Relation of patient age to premalignant alterations in choledochal cyst epithelium: Histochemical and immunohistochemical studies

Komi, Nobuhiko; Tamura, Toshikazu; Tsuge, Shiro; Miyoshi, Yasuyuki; Udaka, Hidenori; Takehara, Hiroo

doi:10.1016/s0022-3468(86)80514-0

Cited by 61 publications

(27 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…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 . Premalignant alterations in the epithelial wall of the cyst increase with age 65 , which is in accordance with the agerelated cancer incidence 60 . Both dilated and undilated non-cancerous parts of the bile duct in patients with an APBDJ exhibit k-ras and p53 mutations, reflecting the high risk of malignant change in the biliary epithelium 66,67 .…”

Section: Malignancysupporting

confidence: 73%

Bile duct cysts in adults

Søreide

Kørner

Havnen

et al. 2004

British Journal of Surgery

179

191

View full text Add to dashboard Cite

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.

show abstract

Section: Malignancysupporting

confidence: 73%

Bile duct cysts in adults

Søreide

Kørner

Havnen

et al. 2004

British Journal of Surgery

179

191

View full text Add to dashboard Cite

show abstract

“…4,5 The importance of choledochal cysts lies in the lethal complications such as biliary stasis, cholangitis, cholelithiasis, pancreatitis, [15][16][17] and malignant transformation. [18][19][20][21][22] To date, total excision of the cyst remains the choice of treatment. [4][5][6][7] In patients with choledochal cyst, an anomalous junction between the common bile duct and pancreatic duct is often seen in both pediatric and adult patients.…”

Section: Introductionmentioning

confidence: 99%

Choledochal Cysts: Differences Between Pediatric and Adult Patients

Huang

Chen

2010

Journal of Gastrointestinal Surgery

View full text Add to dashboard Cite

Choledochal cysts in children and adults are believed to be different, but direct comparison between them is lacking in the literature. This study was aimed to identify the clinicopathological differences between 42 children and 59 adults with choledochal cyst treated by same surgeons at the Cathay General Hospital. The mean follow-up period was 8.9 years. The result showed that the female-to-male ratios were 1.5:1 in pediatric patients and 4.9:1 in adult patients. Compared with adults with choledochal cyst, the pediatric patients presented more abdominal mass (52.4% vs 21.2%, P = 0.002) and less abdominal pain (76.2% vs. 98.0%, P = 0.002), are more frequently associated with anomalous pancreaticobiliary ductal union (85.7% vs. 59.6%, P = 0.005) and sudden severe stenosis of terminal choledochus (76.2% vs. 42.3%, P = 0.001), are less commonly associated with choledocholithiasis, are not associated with malignant transformation (0% vs 21.2%), and have fewer perioperative and long-term complications. Nevertheless, patients who received total excision had fewer surgical complications in both groups. This result shows that choledochal cysts in pediatric and adult patients are different in clinicopathological manifestations, prognosis, and the underlying abnormalities of the pancreaticobiliary system, suggesting that patients with choledochal cyst should be managed according to these differences.

show abstract

“…Multiple factors such as mechanical irritation by calculi, bile stasis, and bacterial infection seem to be factors in the etiology of biliary carcinoma. A further specific and well-documented risk factor for biliary cancer is congenital choledochal cyst, which is almost always associated with the anomalous arrangement of the pancreatobiliary duct system [7, 8]. This anomaly allows reflux of pancreatic juice into the biliary tree.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, the pancreatic juice is transformed into its activated form by the admixture with bile [2]. Komi et al [8]have reported a high incidence of pyloric and/or intestinal metaplasia of the biliary epithelium in patients over 4 years of age with choledochal cyst, and an incidence of adenocarcinoma as high as 22% after 18 years of age. The presence of bile stasis, sustained infection, and reflux of activated pancreatic juice can play a critical role in carcinogenesis.…”

Section: Discussionmentioning

confidence: 99%

Bile Duct Cancer Developing 21 Years after Choledochoduodenostomy

et al. 2003

View full text Add to dashboard Cite

Background: Cholangiocarcinoma in patients with choledochoenterostomy has been a rare condition with few cases reported in the literature written in English, and there have been few pathological descriptions of this disease. However, it has recently been documented as a late complication of choledochoenteric anastomosis, and has become a serious issue today since choledochoenterostomy and sphincteroplasty for benign biliary lesions were frequently resorted to in the 1970s and 1980s. The authors here present a case of a 67-year-old woman who developed a cholangiocarcinoma 21 years after choledochoduodenostomy. Methods: The patient underwent a curative resection of the tumor with a hepatopancreatoduodenectomy after a detailed preoperative assessment, including cholangiography and cholangioscopy. Results: Although this tumor has been reported to have a poor prognosis, a precise preoperative evaluation and aggressive surgery may contribute to better survival. Pathologically, the tumor originated in the bile duct mucosa of the choledochoduodenostomy, and was accompanied by intestinal and pyloric gland-like metaplasia. Conclusion: These epithelial changes presumably induced by chronic inflammation due to the reflux of intestinal contents and bile stasis may be responsible for the carcinogenesis.

show abstract

Relation of patient age to premalignant alterations in choledochal cyst epithelium: Histochemical and immunohistochemical studies

Cited by 61 publications

References 6 publications

Bile duct cysts in adults

Bile duct cysts in adults

Choledochal Cysts: Differences Between Pediatric and Adult Patients

Bile Duct Cancer Developing 21 Years after Choledochoduodenostomy

Contact Info

Product

Resources

About