Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
HPB (Oxford). 2007;9(5):383-7. doi: 10.1080/13651820701646198.
Choledochal cysts are dilations of the biliary tree. Although commonly reported in Asian populations, the incidence outside of Asia is as low as 1:150 000. The largest series of patients with choledochal cyst disease outside of Asia is this one, studying 70 patients treated in Vancouver between 1971 and 2003.
This was a retrospective chart review.
In all, 19 paediatric and 51 adult patients were evaluated; 21% of paediatric and 25% of adult patients were Asian. All paediatric patients had type I or IV cysts, whereas adult patients represented the different subtypes. Abdominal pain was the presenting symptom in 79% of children and 88% of adults, vomiting was present in 42% of children and 63% of adults and jaundice was seen in 31.5% of children and 39% of adults. Ultrasound was used in 94.7% of children, and ERCP in 80% of adults. In all, 84% of paediatric patients, 100% of adult patients with type I cysts and 85.7% of adult patients with type IV cysts received complete cyst excision and Roux-en-Y hepaticojejunostomy. Complications in both groups were low.
Although Vancouver does have a large Asian population, this does not explain how common choledochal cysts are in this city. Although some authors argue that paediatric and adult disease are caused by different aetiologies, presentation patterns in our study between the two groups were very similar. We recommend complete cyst excision and Roux-en-Y hepaticojejunostomy as the surgery of choice, and advocate early surgery after diagnosis to promote ease of surgery and prevention of future complications.
胆总管囊肿是胆道的扩张。虽然在亚洲人群中常见，但在亚洲以外的发病率低至 1:150000。本文报道了亚洲以外最大系列的胆总管囊肿疾病患者，研究了 1971 年至 2003 年期间在温哥华治疗的 70 例患者。
这是一项回顾性图表回顾。
共评估了 19 例儿科和 51 例成年患者；21%的儿科和 25%的成年患者为亚洲人。所有儿科患者均为 I 型或 IV 型囊肿，而成年患者则代表不同的亚型。腹痛是 79%的儿童和 88%的成人的首发症状，呕吐见于 42%的儿童和 63%的成人，黄疸见于 31.5%的儿童和 39%的成人。94.7%的儿童使用超声检查，80%的成人使用 ERCP。所有儿科患者中，84%、I 型囊肿的所有成年患者 100%和 IV 型囊肿的 85.7%成年患者均接受了完整的囊肿切除和 Roux-en-Y 肝肠吻合术。两组的并发症均较低。
尽管温哥华有大量的亚洲人口，但这并不能解释胆总管囊肿在这个城市有多常见。尽管有些作者认为儿科和成年疾病是由不同的病因引起的，但我们研究中两组之间的表现模式非常相似。我们建议行完整的囊肿切除和 Roux-en-Y 肝肠吻合术作为首选手术，并提倡早期诊断后手术，以促进手术的简便性和预防未来的并发症。
