Risk of bile duct carcinogenesis after excision of extrahepatic bile ducts in pancreaticobiliary maljunction

Susumu Kobayashi, Takehide Asano, Masato Yamasaki, Takashi Kenmochi, Toshio Nakagohri, Takenori Ochiai

Research output: Contribution to journalArticle

114 Citations (Scopus)

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 languageEnglish
Pages (from-to)939-944
Number of pages6
JournalSurgery
Volume126
Issue number5
DOIs
Publication statusPublished - 01-01-1999
Externally publishedYes

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Extrahepatic Bile Ducts
Bile Ducts
Carcinogenesis
Biliary Tract
Choledochal Cyst
Carcinoma
Pancreatic Juice
Dilatation
Incidence
Population

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Kobayashi, Susumu ; Asano, Takehide ; Yamasaki, Masato ; Kenmochi, Takashi ; Nakagohri, Toshio ; Ochiai, Takenori. / Risk of bile duct carcinogenesis after excision of extrahepatic bile ducts in pancreaticobiliary maljunction. In: Surgery. 1999 ; Vol. 126, No. 5. pp. 939-944.
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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.",
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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 journalArticle

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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

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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.

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