Abstract：
BACKGROUND: This study aimed to reveal the early and late postoperative complications and outcomes after surgery for congenital biliary dilatation (CBD) by reviewing cases over the past 40 years.
METHODS: We retrospectively evaluated 59 patients with CBD who underwent radical surgery for complications and outcomes, based on medical records. Early complications were defined as those requiring treatment within 5 years of the initial operation. Late complications were defined as those treated more than 5 years later.
RESULTS: The median age at the first surgery was 37 months. Regarding biliary reconstruction, 54 of the 59 patients (91.5%) underwent hepaticojejunostomy. Although three patients underwent cholecystoduodenostomy and one patient underwent hepaticoduodenostomy, all were converted to hepaticojejunostomy after a median of 12.5 years. One patient developed synchronous biliary carcinoma and underwent pancreaticoduodenectomy. Early complications occurred in seven patients with 10 events (surgical site infection, n = 3 bile leakage, n = 3; ileus, n = 3; bile duct obstruction, n = 1 and intussusception, n = 1). Late complications occurred in nine patients with 12 events (ileus, n = 3; anastomotic stricture, n = 3; hepatolithiasis, n = 3; asynchronous biliary carcinoma, n = 2; pancreatolithiasis, n = 1). Two of the three patients with hepatolithiasis underwent hepatectomy refractory to the endoscopic approach. Two patients developed asynchronous biliary carcinoma at 34 and 13 years after last operation; both ultimately died of the carcinoma. Only 35 patients (61.4%) underwent a follow-up examination. A total of 11 female patients (45.8%) eventually married, and all successfully gave birth.
CONCLUSIONS: Although the long-term prognosis is excellent with complete cyst excision and hepaticojejunostomy, we emphasize the importance of long-term follow-up.
METHODS: We retrospectively evaluated 59 patients with CBD who underwent radical surgery for complications and outcomes, based on medical records. Early complications were defined as those requiring treatment within 5 years of the initial operation. Late complications were defined as those treated more than 5 years later.
RESULTS: The median age at the first surgery was 37 months. Regarding biliary reconstruction, 54 of the 59 patients (91.5%) underwent hepaticojejunostomy. Although three patients underwent cholecystoduodenostomy and one patient underwent hepaticoduodenostomy, all were converted to hepaticojejunostomy after a median of 12.5 years. One patient developed synchronous biliary carcinoma and underwent pancreaticoduodenectomy. Early complications occurred in seven patients with 10 events (surgical site infection, n = 3 bile leakage, n = 3; ileus, n = 3; bile duct obstruction, n = 1 and intussusception, n = 1). Late complications occurred in nine patients with 12 events (ileus, n = 3; anastomotic stricture, n = 3; hepatolithiasis, n = 3; asynchronous biliary carcinoma, n = 2; pancreatolithiasis, n = 1). Two of the three patients with hepatolithiasis underwent hepatectomy refractory to the endoscopic approach. Two patients developed asynchronous biliary carcinoma at 34 and 13 years after last operation; both ultimately died of the carcinoma. Only 35 patients (61.4%) underwent a follow-up examination. A total of 11 female patients (45.8%) eventually married, and all successfully gave birth.
CONCLUSIONS: Although the long-term prognosis is excellent with complete cyst excision and hepaticojejunostomy, we emphasize the importance of long-term follow-up.
摘要：
背景：这项研究旨在通过回顾过去40年的病例，揭示先天性胆道扩张（CBD）手术后的早期和晚期并发症和结局。
方法：我们回顾性评估了59例接受根治性手术的CBD患者的并发症和结果，根据医疗记录.早期并发症定义为在初次手术后5年内需要治疗的并发症。晚期并发症定义为治疗超过5年。
结果：首次手术的中位年龄为37个月。关于胆道重建，59例患者中有54例（91.5％）接受了肝空肠吻合术。尽管三名患者接受了胆囊十二指肠造口术，一名患者接受了肝十二指肠造口术，所有患者均在中位12.5年后转行肝空肠吻合术.一名患者发展为同步胆道癌并接受了胰十二指肠切除术。7例患者发生早期并发症，共发生10个事件（手术部位感染，n=3胆漏，n=3；肠梗阻，n=3；胆管阻塞，n=1和肠套叠，n=1)。晚期并发症发生在9例患者中，有12例事件（肠梗阻，n=3；吻合口狭窄，n=3;肝胆管结石,n=3；异步胆道癌，n=2;胰管结石,n=1)。三例肝胆管结石患者中有两例接受了内镜下难治性肝切除术。上一次手术后34年和13年，两名患者发生了异步胆道癌；最终均死于癌症。只有35例患者（61.4％）接受了随访检查。共有11名女性患者(45.8%)最终结婚，所有人都成功分娩了。
结论：尽管完全囊肿切除和肝空肠吻合术的长期预后良好，我们强调长期后续行动的重要性。
方法：我们回顾性评估了59例接受根治性手术的CBD患者的并发症和结果，根据医疗记录.早期并发症定义为在初次手术后5年内需要治疗的并发症。晚期并发症定义为治疗超过5年。
结果：首次手术的中位年龄为37个月。关于胆道重建，59例患者中有54例（91.5％）接受了肝空肠吻合术。尽管三名患者接受了胆囊十二指肠造口术，一名患者接受了肝十二指肠造口术，所有患者均在中位12.5年后转行肝空肠吻合术.一名患者发展为同步胆道癌并接受了胰十二指肠切除术。7例患者发生早期并发症，共发生10个事件（手术部位感染，n=3胆漏，n=3；肠梗阻，n=3；胆管阻塞，n=1和肠套叠，n=1)。晚期并发症发生在9例患者中，有12例事件（肠梗阻，n=3；吻合口狭窄，n=3;肝胆管结石,n=3；异步胆道癌，n=2;胰管结石,n=1)。三例肝胆管结石患者中有两例接受了内镜下难治性肝切除术。上一次手术后34年和13年，两名患者发生了异步胆道癌；最终均死于癌症。只有35例患者（61.4％）接受了随访检查。共有11名女性患者(45.8%)最终结婚，所有人都成功分娩了。
结论：尽管完全囊肿切除和肝空肠吻合术的长期预后良好，我们强调长期后续行动的重要性。
