Long-term outcomes of surgery for choledochal cysts: a single-institution study focusing on follow-up and late complications

Purpose The late postoperative complications of choledochal cyst (CC) surgery are serious and include intrahepatic stones and biliary carcinoma; therefore, long-term follow-up is crucial. Methods The subjects of this retrospective study were patients who underwent surgery for CC at Kagoshima Univers...

Full description

Saved in:
Bibliographic Details
Published in:Surgery today (Tokyo, Japan) Japan), 2018-09, Vol.48 (9), p.835-840
Main Authors: Mukai, Motoi, Kaji, Tatsuru, Masuya, Ryuta, Yamada, Koji, Sugita, Koshiro, Moriguchi, Tomoe, Onishi, Shun, Yamada, Waka, Kawano, Takafumi, Machigashira, Seiro, Nakame, Kazuhiko, Takamatsu, Hideo, Ieiri, Satoshi
Format: Article
Language:English
Subjects:
Medicine
Medicine & Public Health
Original Article
Surgery
Surgical Oncology
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Purpose The late postoperative complications of choledochal cyst (CC) surgery are serious and include intrahepatic stones and biliary carcinoma; therefore, long-term follow-up is crucial. Methods The subjects of this retrospective study were patients who underwent surgery for CC at Kagoshima University Hospital between April, 1984 and December, 2016. We analyzed the operative results, early and late postoperative complications, and postoperative follow-up rate. Results The study population comprised 110 CC patients (male/female: 33/77) with a median age at surgery of 4 years, 3 months (range 12 days–17 years). The patients underwent hepaticoduodenostomy ( n  = 1; 0.9%) or hepaticojejunostomy ( n  = 109; 99.1%). Late complications included intrahepatic bile duct (IHBD) dilatation ( n  = 1; 0.9%), IHBD stones ( n  = 3; 2.7%), and adhesive ileus ( n  = 4; 3.6%). There was no incidence of biliary carcinoma in this series. The rates of follow-up at our institute within 10 years of surgery and more than 20 years after surgery were 69.2% (18 of 26) and 14.5% (8 of 55), respectively. Conclusions The follow-up rate after definitive surgery declined with time. Late complications were observed within 20 years, but biliary carcinoma was not observed. The follow-up rate should be increased to detect late complications. Moreover, patient education on long-term follow up is essential to prevent life-threatening events after definitive surgery for CC.
ISSN:0941-1291
1436-2813
DOI:10.1007/s00595-018-1660-9