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Impact of previous cyst-enterostomy on patients' outcome following resection of bile duct cysts

World Journal of Gastrointestinal Surgery 2016年第6期8卷 427-435页

作者： Mehdi Ouaissi Reza Kianmanesh Emilia Ragot Jacques Belghiti Pietro Majno Gennaro Nuzzo Remi Dubois Yann Revillon Daniel Cherqui Daniel Azoulay Christian Letoublon Frane is-Rene Pruvot Francois Paye Patrick Rat Karim Boudjema adeline roux Jean-Yves Mabrut Jean-François Gigot Department of General and Digestive Surgery La Timone Hospital13009 MarseilleFrance Department of Digestive and Endocrine Surgery Robert DebréHospital51090 ReimsFrance Department of HPB Surgery Beaujon Hospital92110 ClichyFrance Department of Digestive Surgery Geneva University Hospital1205 GenevaSwitzerland Department of HPB Surgery Gemelli University Hospital00168 RomaItaly Department of Pediatric Surgery Mother and Children Hospital69677 BronFrance Department of Pediatric Digestive Surgery Necker Hospital75175 ParisFrance Department of Digestive and HPB Surgery Paul Brousse Hospital94800 VillejuifFrance Department of Digestive and HPB Surgery Henri Mondor Hospital94000 CreteilFrance Department of Digestive Surgery Michallon Hospital38043 GrenobleFrance Department of Digestive surgery and Transplantation Claude Huriez Hospital59037 LilleFrance Department of Digestive Surgery Saint Antoine Hospital75012 ParisFrance Department of Digestive Surgery Dijon University Hospital21000 DijonFrance Department of HPB Surgery Pontchaillou Hospital35033 RennesFrance Pôle Information Médicale Evaluation Recherche Unitéde Recherche Clinique69317 LyonFrance Department of Digestive Surgery and Hepatic Transplantation La Croix-Rousse Hospital69317 LyonFrance Department of Abdominal Surgery and Transplantation Division of Hepato-Biliary and Pancreatic Surgery Cliniques Universitaires Saint-Luc 1200 BrusselsBelgium

AIM:To analyze the impact of previous cyst-enterostomy of patients underwent congenital bile duct cysts(BDC)***:A multicenter European retrospective study between 1974 and 2011 were conducted by the French Surgical *** Todani subtypes I and IVb were *** imaging studies and operative and pathology reports underwent central *** with and without a previous history of cystenterostomy(CE)were ***: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 *** 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.

关键词： Bile duct cyst Congenital Biliary disease Cyst-enterostomy Long-term outcome

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