Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 463-707, Korea.
Korean J Radiol. 2012 Jan-Feb;13 Suppl 1(Suppl 1):S112-6. doi: 10.3348/kjr.2012.13.S1.S112. Epub 2012 Apr 23.
The aim of this study was to evaluate the frequency of postoperative biliary stricture and its risk factors in patients undergoing surgery for type I choledochal cyst.
A total of 35 patients with type I choledochal cyst underwent laparoscopic cyst excision and Roux-en-Y hepaticojejunostomy between August 2004 and August 2011. Their medical records and radiologic images (including endoscopic retrograde cholangiopancreatography, magnetic resonance cholangiopancreatography, pancreatobiliary computed tomography, or ultrasound) were retrospectively analyzed to evaluate the frequency of postoperative biliary stricture and its risk factors.
Postoperative biliary stricture was found in 10 (28.6%) of 35 patients. It developed more frequently in patients with type Ia choledochal cyst (53.8%, 7 of 13 patients) than in patients with type Ic choledochal cyst (13.6%, 3 of 22 patients), which was statistically significant (p = 0.011). There were no significant associations between other factors and postoperative biliary stricture.
Type Ia is a risk factor of postoperative anastomotic stricture. Therefore, preoperative radiologic subclassification of type Ia and Ic may be useful in predicting postoperative outcomes of choledochal cysts.
本研究旨在评估 1 型胆总管囊肿患者行手术治疗后发生胆管狭窄的频率及其危险因素。
2004 年 8 月至 2011 年 8 月，共 35 例 1 型胆总管囊肿患者接受腹腔镜囊肿切除和 Roux-en-Y 肝肠吻合术。回顾性分析其病历和影像学图像（包括内镜逆行胰胆管造影、磁共振胰胆管造影、胰胆管计算机断层扫描或超声），以评估术后胆管狭窄的发生频率及其危险因素。
35 例患者中有 10 例（28.6%）发生术后胆管狭窄。13 例 1a 型胆总管囊肿患者中，胆管狭窄发生率为 53.8%（7/13 例），明显高于 22 例 1c 型胆总管囊肿患者的 13.6%（3/22 例），差异有统计学意义（p = 0.011）。其他因素与术后胆管狭窄之间无明显相关性。
1a 型是术后吻合口狭窄的危险因素。因此，术前对 1a 型和 1c 型进行影像学分类可能有助于预测胆总管囊肿的术后结果。
