Wu X, Li BL, Zheng CJ, He XD. Risk factors for preoperative carcinogenesis of bile duct cysts in adults. World J Clin Cases 2021; 9(22): 6278-6286 [PMID: 34434994 DOI: 10.12998/wjcc.v9.i22.6278]
Corresponding Author of This Article
Bing-Lu Li, MD, Professor, Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China. pumchlibinglu@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Aug 6, 2021; 9(22): 6278-6286 Published online Aug 6, 2021. doi: 10.12998/wjcc.v9.i22.6278
Risk factors for preoperative carcinogenesis of bile duct cysts in adults
Xin Wu, Bing-Lu Li, Chao-Ji Zheng, Xiao-Dong He
Xin Wu, Bing-Lu Li, Chao-Ji Zheng, Xiao-Dong He, Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Author contributions: All authors helped to perform the research; Wu X designed and performed the research and wrote the paper; Li BL designed the research and supervised the report; Zheng CJ and He XD contributed to the analysis and provided clinical advice.
Supported bythe Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences, No. 2019XK320012.
Institutional review board statement: This study was reviewed and approved by the Peking Union Medical College Hospital Institutional Review Board (S-K1483).
Informed consent statement: The requirement of informed consent for publication of data was waived owing to the retrospective nature of the study.
Conflict-of-interest statement: The authors declare no conflict of interests for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bing-Lu Li, MD, Professor, Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China. pumchlibinglu@163.com
Received: April 11, 2021 Peer-review started: April 11, 2021 First decision: April 23, 2021 Revised: May 6, 2021 Accepted: May 19, 2021 Article in press: May 19, 2021 Published online: August 6, 2021
Abstract
BACKGROUND
Bile duct cyst (BDC) is a rare congenital bile duct malformation. The incidence of bile duct malignancy in BDC patients is markedly higher than that in the general population. However, few studies have been conducted on the risk factors for preoperative carcinogenesis in BDC patients.
AIM
To analyze the risk factors associated with preoperative carcinogenesis in BDC patients.
METHODS
The medical records of BDC patients treated at our hospital between January 2012 and December 2018 were retrospectively reviewed. We constructed a database and compared the characteristics of BDC patients with dysplasia and carcinoma against those with benign cysts. The risk factors for preoperative carcinogenesis were identified using univariate and multivariate analyses.
RESULTS
The cohort comprised 109 BDC patients. Ten patients had preoperative dysplasia or adenocarcinoma. Univariate and multivariate analyses showed that gallbladder wall thickness > 0.3 cm [odds ratio (OR), 6.551; 95% confidence interval (CI), 1.351 to 31.763; P = 0.020] and Todani type IV (OR, 7.675; 95%CI, 1.584 to 37.192; P = 0.011) were independent factors associated with preoperative carcinogenesis.
CONCLUSION
BDC is a premalignant condition. Our findings show that gallbladder wall thickness > 0.3 cm and Todani type IV are independent risk factors for preoperative carcinogenesis of BDC. They are therefore useful for deciding on the appropriate treatment strategy, especially in asymptomatic patients.
Core Tip: Bile duct cyst (BDC) is a rare congenital bile duct malformation that is more common in Asian countries. The incidence of bile duct malignancy in BDC patients is 20- to 30-fold higher than that in the general population. However, few studies have been conducted on the risk factors for preoperative carcinogenesis of BDC. The present study retrospectively analyzed 109 BDC patients and found that gallbladder wall thickness > 0.3 cm and Todani type IV were independently associated with preoperative carcinogenesis. The clinical data and long-term follow-up information of ten BDC patients with dysplasia or carcinoma were also presented.
