AIM:To analyze the impact of previous cyst-enterostomy of patients underwent congenital bile duct cysts(BDC) resection.METHODS:A multicenter European retrospective study between 1974 and 2011 were conducted by the Fre...AIM:To analyze the impact of previous cyst-enterostomy of patients underwent congenital bile duct cysts(BDC) resection.METHODS:A multicenter European retrospective study between 1974 and 2011 were conducted by the French Surgical Association.Only Todani subtypes I and IVb were included.Diagnostic imaging studies and operative and pathology reports underwent central revision.Patients with and without a previous history of cystenterostomy(CE) were compared.RESULTS:Among 243 patients with Todani types I and IVb BDC,16 had undergone previous CE(6.5%).Patients with a prior history of CE experienced a greater incidence of preoperative cholangitis(75% vs 22.9%,P < 0.0001),had more complicated presentations(75% vs 40.5%,P = 0.007),and were more likely to have synchronous biliary cancer(31.3% vs 6.2%,P = 0.004) than patients without a prior CE.Overall morbidity(75% vs 33.5%;P < 0.0008),severe complications(43.8% vs 11.9%;P = 0.0026) and reoperation rates(37.5% vs 8.8%;P = 0.0032) were also significantly greater in patients with previous CE,and their Mayo Risk Score,during a median follow-up of 37.5 mo(range:4-372 mo) indicated significantly more patients with fair and poor results(46.1% vs 15.6%;P = 0.0136).CONCLUSION:This is the large series to show that previous CE is associated with poorer short-and longterm results after Todani types I and IVb BDC resection.展开更多
文摘AIM:To analyze the impact of previous cyst-enterostomy of patients underwent congenital bile duct cysts(BDC) resection.METHODS:A multicenter European retrospective study between 1974 and 2011 were conducted by the French Surgical Association.Only Todani subtypes I and IVb were included.Diagnostic imaging studies and operative and pathology reports underwent central revision.Patients with and without a previous history of cystenterostomy(CE) were compared.RESULTS:Among 243 patients with Todani types I and IVb BDC,16 had undergone previous CE(6.5%).Patients with a prior history of CE experienced a greater incidence of preoperative cholangitis(75% vs 22.9%,P < 0.0001),had more complicated presentations(75% vs 40.5%,P = 0.007),and were more likely to have synchronous biliary cancer(31.3% vs 6.2%,P = 0.004) than patients without a prior CE.Overall morbidity(75% vs 33.5%;P < 0.0008),severe complications(43.8% vs 11.9%;P = 0.0026) and reoperation rates(37.5% vs 8.8%;P = 0.0032) were also significantly greater in patients with previous CE,and their Mayo Risk Score,during a median follow-up of 37.5 mo(range:4-372 mo) indicated significantly more patients with fair and poor results(46.1% vs 15.6%;P = 0.0136).CONCLUSION:This is the large series to show that previous CE is associated with poorer short-and longterm results after Todani types I and IVb BDC resection.
