Söreide K, Körner H, Havnen J, Söreide J A
Department of Surgery, University of Bergen, Stavanger, Norway.
Br J Surg. 2004 Dec;91(12):1538-48. doi: 10.1002/bjs.4815.
Bile duct cysts are rare and of uncertain origin. Most have been reported in young females of Asian descent, but an increasing number have occurred in Western adults.
A Medline literature search was performed to locate articles on the pathophysiological concepts, clinical behaviour and management controversies pertaining to bile duct cysts in adults. Emphasis was placed on reports from the past two decades.
An increasing rate of occurrence of bile duct cyst is reported in adults. Type IV cysts are more frequent in adults than children. Presentation tends to be non-specific abdominal discomfort. Related hepatobiliary or pancreatic disease frequently precedes recognition, and may complicate the postoperative course. Surgical treatment aims to relieve complications deriving from the cysts and to reduce the significant risk of malignant change within the biliary tree. Complete cyst resection, cholecystectomy and Roux-en-Y hepaticojejunostomy reconstruction is standard. Controversy exists about the role of hepatic resection in type IV and V cysts, and the role of minimally invasive and laparoscopic treatment. In general, the outcome is good and a near-zero mortality rate has been reported in institutional series over the past decade.
胆管囊肿罕见且起源不明。大多数病例报道于亚裔年轻女性，但西方成年人中发病的病例数也在增加。
进行了一项医学文献检索，以查找有关成人胆管囊肿的病理生理概念、临床行为和治疗争议的文章。重点关注过去二十年的报告。
据报道，成人胆管囊肿的发病率在上升。IV型囊肿在成人中比儿童中更常见。表现往往是非特异性的腹部不适。相关的肝胆或胰腺疾病常在确诊之前出现，且可能使术后病程复杂化。手术治疗旨在缓解囊肿引起的并发症，并降低胆管树内发生恶性病变的重大风险。标准术式为完整囊肿切除、胆囊切除及 Roux-en-Y 肝空肠吻合重建。对于IV型和V型囊肿，肝切除的作用以及微创和腹腔镜治疗的作用存在争议。总体而言，预后良好，在过去十年的机构系列报道中死亡率接近零。
