Open AccessLong‐term outcomes after biliary diversion operation for pancreaticobiliary maljunction in adult patients
Author(s) -
Aota Takanori,
Kubo Shoji,
Takemura Shigekazu,
Tanaka Shogo,
Amano Ryosuke,
Kimura Kenjiro,
Yamazoe Sadaaki,
Shinkawa Hiroji,
Ohira Go,
Shibata Toshihiko,
Horiike Masaki
Publication year - 2019
Publication title -
annals of gastroenterological surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.308
H-Index - 15
ISSN - 2475-0328
DOI - 10.1002/ags3.12239
Subject(s) - hepatolithiasis , medicine , gastroenterology , biliary tract , pancreatic cancer , bile duct cancer , cancer , surgery , hepatectomy , resection
Aim Pancreaticobiliary maljunction (PBM) with or without congenital biliary dilatation ( CBD ) is a risk factor for biliary tract cancer. We investigated long‐term outcomes after biliary diversion operation with special reference to types of CBD . Methods Subjects comprised 40 adult patients who underwent biliary diversion operation for PBM without biliary tract cancer. Group A comprised 20 patients with type Ia or Ic CBD , or non‐dilated bile ducts, while group B comprised 20 patients with type IV ‐A CBD . The clinical findings and postoperative outcomes were compared between groups. Results Of 40 patients, nine patients suffered from repeated cholangitis and eight of these nine patients suffered from hepatolithiasis after biliary diversion operation. Biliary tract cancer or pancreatic cancer was detected in four patients at 3 years and 2 months to 24 years after the operation. In three of these four patients, the serum concentration of carbohydrate antigen 19‐9 increased before detection of carcinoma. One patient died of hepatic failure due to repeated cholangitis. The proportions of patients with repeated cholangitis, hepatolithiasis, and re‐operation, and patients who died of biliary tract cancer, pancreatic cancer, or hepatic failure, were significantly higher in group B than in group A. The survival rate was significantly worse in group B than in group A. Conclusions Careful long‐term follow‐up with measurement of serum tumor markers is necessary after biliary diversion operation for PBM, especially in patients with type IV ‐A CBD or repeated cholangitis.