Komi N, Tamura T, Miyoshi Y, Kunitomo K, Udaka H, Takehara H
Surg Gastroenterol. 1984;3(2):69-73.
A nationwide survey of cases of choledochal cyst was conducted to obtain the data on cases of choledochal cyst in Japan between 1972 and 1982. A total of 645 cases in 73 institutions, including 52 cases from this hospital, were surveyed. Choledochal cyst was associated with an anomalous arrangement of the pancreaticobiliary ductal system in 90.2% of the cases which were examined extensively. The serum amylase level was elevated in 26.6% of the cases. Calculus disease of the biliary duct was recognized in 28.5% of the cases. Biliary carcinoma developed in 54 (8.4%) of 645 cases. The incidences of biliary carcinoma were 0.3% (1/306) in cases in children and 15.6% (53/339) in adult cases; carcinoma was found in the wall of the choledochus in 30, and in the gallbladder in 16 of these 54 cases. The nationwide survey showed that an anomalous arrangement of the pancreaticobiliary ductal system was closely associated with choledochal cyst and that cases of biliary carcinoma developed with the advance of age. Therefore, early resection of the cyst wall and reconstruction of the biliary duct is proposed as suitable surgical treatment for stopping reflux of pancreatic juice into the biliary duct.
为获取1972年至1982年间日本胆总管囊肿病例的数据，开展了一项全国性的胆总管囊肿病例调查。对73家机构的645例病例进行了调查，其中包括本院的52例。在接受详细检查的病例中，90.2%的胆总管囊肿与胰胆管系统的异常排列有关。26.6%的病例血清淀粉酶水平升高。28.5%的病例发现有胆管结石病。645例病例中有54例（8.4%）发生胆管癌。儿童病例胆管癌的发病率为0.3%（1/306），成人病例为15.6%（53/339）；在这54例病例中，30例胆管癌发生在胆总管壁，16例发生在胆囊。全国性调查显示，胰胆管系统的异常排列与胆总管囊肿密切相关，且胆管癌病例随年龄增长而增多。因此，建议早期切除囊肿壁并重建胆管，作为阻止胰液反流至胆管的合适手术治疗方法。
