Biliary Tree Cysts and Surgical Treatment: Outcomes in a Multicentric Study
Por:
Ferrari, C, Rodriguez, MB, Molina, V, Martin, B, Espinet, M, Percivale, A, Griseri, G, Moral, A, Sanchez-Cabus, S
Publicada:
14 mar 2022
Ahead of Print:
1 may 2021
Resumen:
Background: Biliary tree cysts (BTCs) represent an either localized or multifocal abnormal dilatation of the biliary tree, which entails an increased risk of acute cholangitis and cholangiocarcinoma (2.5%-16%). Its incidence in Western countries is similar to 1/100.000-1/150.000, being more frequent in Asia (1/1.000). These cysts are usually classified according to Todani classification, which is based on site and morphology of cysts.
Patients and Methods: This is a retrospective multicentric descriptive study of patients surgically treated for BTCs. From 2005 to 2018, 25 cases were collected between Hospital de la Santa Creu i Sant Pau (Barcelona, Spain) and Ospedale San Paolo (Savona, Italy). Clinical presentation was characterized by abdominal pain, jaundice, fever, and sometimes weight loss. Eight patients presented Todani type I, 1 patient Todani type II, 3 patients Todani III, 1 patient Todani type IV, and 12 patients Todani type V.
Results: Among the 25 surgically treated patients, 12 patients underwent liver resection, 7 patients underwent resection of the extrahepatic biliary tree, 3 patients underwent BTC removal through a duodenotomy, 1 patient underwent resection of the extrahepatic biliary tree and liver resection, and 2 patients underwent pancreatoduodenectomy. Overall 30-day morbidity rate was 20%, and 90-day mortality was 0%. Pathologic examination confirmed diagnosis of cholangiocarcinoma in 5 patients (20%). After a median follow-up of 59 months, 20 patients are alive and in good conditions, whereas 50% of patients with cholangiocarcinoma died for disease progression.
Conclusions: Surgical treatment for BTCs is associated with acceptable postoperative outcomes, with moderate morbidity and null mortality rates. Moreover, the risk of developing cholangiocarcinoma is still high that prompts surgical treatment once diagnosis is made.
Filiaciones:
Ferrari, C:
Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Dept Surg, Div Hepatobiliarypancreat Surg, Barcelona, Spain
Hosp San Paolo Savona, Dept Surg, Div Hepatobiliarypancreat Surg, Savona, Italy
Hosp Santa Corona Pietra Ligure, Pietra Ligure, Italy
Univ Genoa, IRCCS Oncol & Neurosci, San Martino Policlin Hosp, Dept Gen Surg, Largo Rosanna Benzi 10, I-16132 Genoa, Italy
Rodriguez, MB:
Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Dept Surg, Div Hepatobiliarypancreat Surg, Barcelona, Spain
Molina, V:
Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Dept Surg, Div Hepatobiliarypancreat Surg, Barcelona, Spain
Martin, B:
Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Dept Surg, Div Hepatobiliarypancreat Surg, Barcelona, Spain
Espinet, M:
Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Dept Surg, Div Hepatobiliarypancreat Surg, Barcelona, Spain
Percivale, A:
Hosp San Paolo Savona, Dept Surg, Div Hepatobiliarypancreat Surg, Savona, Italy
Hosp Santa Corona Pietra Ligure, Pietra Ligure, Italy
Griseri, G:
Hosp San Paolo Savona, Dept Surg, Div Hepatobiliarypancreat Surg, Savona, Italy
Hosp Santa Corona Pietra Ligure, Pietra Ligure, Italy
Moral, A:
Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Dept Surg, Div Hepatobiliarypancreat Surg, Barcelona, Spain
Sanchez-Cabus, S:
Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Dept Surg, Div Hepatobiliarypancreat Surg, Barcelona, Spain
|