[Cystic disease of the biliary tract. Three decades of institutional experence].
BACKGROUND
Cystic disease of biliary tract (CDBT) characterizes by the presence of sacular expansions of the biliary tree. It is an uncommon disease associated with high morbidity and malignant transformation. More than 60% of patients are women and can be diagnosed in the adult life.


OBJECTIVE
To evaluate the results obtained during last three decades in the management of CDBT in the adult patient.


METHODS
All the patients with CDBT treated from 1970 to 2002 were included. Demographic data, clinical picture, boarding diagnosis, classification, treatment, evolution and survival were analyzed.


RESULTS
34 patients. Twenty eight (82%) women and 6 (18%) men with a mean age of 33 years (range 13-84). The most frequent symptoms were abdominal pain, nausea-vomit and jaundice. Cholangiography was made in all cases. All the types described by Todani were documented. Twenty-seven patients (80%) were surgically treated. The mean follow-up was 84 months (range 1-408 months). Fifteen patients (44.1%) were readmitted and 9 (26.4%) had a reoperation. Three (9%) died with malignant transformation. The global survival was 91.1% to 12 months.


CONCLUSIONS
In the adult patient, diagnosis of CDBT requires a high level of suspicion and its confirmation depends on the image studies. The CDBT diagnosis considers an indication of surgical treatment. Complete resection of the biliary tract with Roux en-Y hepato-jejunal anastomosis have less rate of mechanical complications, hospitalary readmissions and surgical reintervention.
Plata-Muñoz
Juan José
JJ
Departamento de Cirugía General, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, DF.
Mercado
Miguel Angel
MA
Orozco
Héctor
H
Chan
Carlos
C
Jerez
Luis
L
Torre-Delgadillo
Aldo
A
González
Quintin H
QH
Campuzano
Manuel
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001660:Biliary Tract Diseases / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D003560:Cysts / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors