Abstract
Much about the aetiology, pathophysiology, natural course and optimal treatment of choledochal malformation remains under debate. Surgeons continuously strive to optimize their roles in the management of choledochal malformation. Nowadays the standard treatment is complete cyst excision followed by Roux-en-Y hepaticojejunostomy, be it via a laparotomy, laparoscopy or robot-assisted procedure. Whatever surgical endeavor is undertaken, it will be a major operation, with significant morbidity. It is important to realize that especially in asymptomatic cases, this is considered prophylactic surgery, aimed at preventing symptoms but even more important the development of malignancy later in life. A clear overview of long-term outcomes is therefore necessary. This paper aims to review the long-term outcomes after surgery for choledochal malformation. We will focus on biliary complications such as cholangitis, the development of malignancy and quality of life. We will try and identify factors related to a worse outcome. Finally, we make a plea for a large scale study into quality and course of life after resection of a choledochal malformation, to help patients, parents and their treating physicians to come to a well-balanced decision regarding the treatment of a choledochal malformation.
Highlights
Choledochal malformations (CM) are rare congenital diseases of the biliary tree
Complication is the development of an epithelial malignancy of the affected bile duct or gallbladder. This cholangiocarcinoma is the presenting diagnosis in ~3% adult cases in whom the CM has been asymptomatic until that point, while malignancy is present in a total of eleven percent of patients in whom a CM is resected later in life.[8]
This paper aims to review the long-term morbidity after surgery for choledochal malformation
Summary
Long-term morbidity and follow-up after choledochal malformation surgery; A plea for a quality of life study de Kleine, R. Document Version Publisher's PDF, known as Version of record. Long-term morbidity and follow-up after choledochal malformation surgery; A plea for a quality of life study. More information can be found on the University of Groningen website: https://www.rug.nl/library/open-access/self-archiving-pure/taverneamendment. Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. For technical reasons the number of authors shown on this cover page is limited to 10 maximum
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