[Experience of diagnosis and treatment of carcinoma arising from congenital biliary duct cyst].
OBJECTIVE
To summarize the experience in diagnosis, prevention and treatment of carcinoma arising from congenital biliary duct cyst.


METHODS
The clinical and pathological data of 185 patients with congenital biliary duct cyst admitted to Chinese PLA General Hospital were analyzed retrospectively.


RESULTS
Among 185 patients, twenty-seven cases had carcinomas arising from congenital biliary duct cyst, and the frequency of malignant transformation was 14.6%, which closely related to the age (P < 0.001). The incidences of malignancy for different age groups were: 0 for 0-9 age group, 5.1% for 0-19, 9.1% for 20-29, 16.2% for 30-39, 26.7% for 40-49, 33.3% for 50-59, and 50% for over 60, respectively. Six patients had the history of cyst-enterostomy. Abdominal pain, fever, jaundice and weight loss were the main clinical manifestations. Abdominal ultrasonography, CT, MRI or magnetic resonance cholangiopancreatography, MRCP and endoscopic retrograde choledochopancreatography (ERCP) were the main diagnostic methods. For twenty patients (74.1%), a definite diagnosis was made preoperatively, but it's hard to make an early diagnosis. Nine patients (33.3%) underwent curative resection.


CONCLUSIONS
Congenital biliary duct cyst is a premalignant lesion, and the incidence of carcinogenesis increases remarkably with age. The most effective method for prevention of carcinogenesis in choledochal cyst is complete excision of choledochal cyst during childhood, and the prognosis is poor for patients with biliary malignancy.
Liu
Quan-da
QD
Institute of Hepatobiliary Surgery, General Hospital of People's Libration Army, Beijing 100853, China. liuquanda@sina.com
Zhou
Ning-xin
NX
Huang
Zhi-qiang
ZQ
Zhang
Wen-zhi
WZ
Liu
Gui-lin
GL
Wang
Yue-hua
YH
D000293:Adolescent; D000368:Aged; D002648:Child; D002675:Child, Preschool; D002760:Cholangiopancreatography, Endoscopic Retrograde; D049448:Cholangiopancreatography, Magnetic Resonance; D015529:Choledochal Cyst / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D003138:Common Bile Duct Neoplasms / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed