Abstract
Background. A reflux of pancreatic juice into the biliary tract caused by pancreaticobiliary maljunction (PBM) has been considered important in the development of biliary tract carcinogenesis in choledochal cysts. We excised extrahepatic bile ducts in patients with choledochal cysts to terminate the reflux of pancreatic juice. We investigated whether this surgery could stop the development of the residual bile duct carcinoma. Methods. Fifty-six patients with a diagnosis of PBM with choledochal dilatation underwent surgical excision of extrahepatic bile ducts. We applied a person-year method to compare the relative risks (observed number/expected number) of biliary tract carcinoma before and after surgery. Results. In 3 patients, bile duct carcinoma developed in residual dilated segments 19 years 6 months, 8 years 8 months, and 2 years 5 months, respectively, after surgery. Although the relative risk in the post-surgery group was slightly decreased by surgery, it was still high compared with that of the general population. Conclusions. The incidence of bile duct carcinoma is still high, even after excision of extrahepatic bile ducts in PBM patients with choledochal dilatation. For these patients, careful long-term follow-up is necessary, especially after operations that leave the dilated bile ducts, such as cases of Todani's type IV-A.
| Original language | English |
|---|---|
| Pages (from-to) | 939-944 |
| Number of pages | 6 |
| Journal | Surgery |
| Volume | 126 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - 01-01-1999 |
| Externally published | Yes |
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All Science Journal Classification (ASJC) codes
- Surgery
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Risk of bile duct carcinogenesis after excision of extrahepatic bile ducts in pancreaticobiliary maljunction. / Kobayashi, Susumu; Asano, Takehide; Yamasaki, Masato; Kenmochi, Takashi; Nakagohri, Toshio; Ochiai, Takenori.
In: Surgery, Vol. 126, No. 5, 01.01.1999, p. 939-944.Research output: Contribution to journal › Article
TY - JOUR
T1 - Risk of bile duct carcinogenesis after excision of extrahepatic bile ducts in pancreaticobiliary maljunction
AU - Kobayashi, Susumu
AU - Asano, Takehide
AU - Yamasaki, Masato
AU - Kenmochi, Takashi
AU - Nakagohri, Toshio
AU - Ochiai, Takenori
PY - 1999/1/1
Y1 - 1999/1/1
N2 - Background. A reflux of pancreatic juice into the biliary tract caused by pancreaticobiliary maljunction (PBM) has been considered important in the development of biliary tract carcinogenesis in choledochal cysts. We excised extrahepatic bile ducts in patients with choledochal cysts to terminate the reflux of pancreatic juice. We investigated whether this surgery could stop the development of the residual bile duct carcinoma. Methods. Fifty-six patients with a diagnosis of PBM with choledochal dilatation underwent surgical excision of extrahepatic bile ducts. We applied a person-year method to compare the relative risks (observed number/expected number) of biliary tract carcinoma before and after surgery. Results. In 3 patients, bile duct carcinoma developed in residual dilated segments 19 years 6 months, 8 years 8 months, and 2 years 5 months, respectively, after surgery. Although the relative risk in the post-surgery group was slightly decreased by surgery, it was still high compared with that of the general population. Conclusions. The incidence of bile duct carcinoma is still high, even after excision of extrahepatic bile ducts in PBM patients with choledochal dilatation. For these patients, careful long-term follow-up is necessary, especially after operations that leave the dilated bile ducts, such as cases of Todani's type IV-A.
AB - Background. A reflux of pancreatic juice into the biliary tract caused by pancreaticobiliary maljunction (PBM) has been considered important in the development of biliary tract carcinogenesis in choledochal cysts. We excised extrahepatic bile ducts in patients with choledochal cysts to terminate the reflux of pancreatic juice. We investigated whether this surgery could stop the development of the residual bile duct carcinoma. Methods. Fifty-six patients with a diagnosis of PBM with choledochal dilatation underwent surgical excision of extrahepatic bile ducts. We applied a person-year method to compare the relative risks (observed number/expected number) of biliary tract carcinoma before and after surgery. Results. In 3 patients, bile duct carcinoma developed in residual dilated segments 19 years 6 months, 8 years 8 months, and 2 years 5 months, respectively, after surgery. Although the relative risk in the post-surgery group was slightly decreased by surgery, it was still high compared with that of the general population. Conclusions. The incidence of bile duct carcinoma is still high, even after excision of extrahepatic bile ducts in PBM patients with choledochal dilatation. For these patients, careful long-term follow-up is necessary, especially after operations that leave the dilated bile ducts, such as cases of Todani's type IV-A.
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U2 - 10.1016/S0039-6060(99)70036-X
DO - 10.1016/S0039-6060(99)70036-X
M3 - Article
VL - 126
SP - 939
EP - 944
JO - Surgery
JF - Surgery
SN - 0039-6060
IS - 5
ER -