Risk Factors Of Adult Congenital Choledochal Cyst Carcinogenesis

Objective: To study the risk factors of carcinogenesis of congenital choledochal cyst in adults and to provide reference for prevention of carcinogenesis of choledochal cyst.Methods: The data of 46 cases of congenital choledochal cyst from January 1997 to January 2017 in the first affiliated Hospital of Dalian Medical University were analyzed retrospectively.There were 32 female patients and 14 male patients.The ratio of male and female was 1: 3,the oldest was 76 years old,the youngest 18 years old,the average age was 38.4 years.The clinical symptoms were mostly abdominal pain(86.9%),jaundice(39.1%).Fever(34.8%),nausea or vomiting(52.1%),abdominal mass(2.17%),and cholangitis(21.7%)Cholecystitis(21.7%),cholelithiasis(32.6%),gallstone(11(23.9%),biliary drainage(3 cases)(6.52%),cholecystitis(21.7%),cholecystolithiasis(32.6%),cholecystolithiasis(23.9%).Postoperative pathological results suggested cancer in 8 cases(17.4%).According to the postoperative pathological results,they were divided into two groups: canceration group and non-cancerous group.Sex,age,abdominal pain,jaundice,abdominal mass,fever,nausea or vomiting,cholangitis,cholelithiasis,cholecystitis,cholecystitis were analyzed.The differences of biliary drainage history,urban / rural area and other related indexes were analyzed by Logistics regression analysis.Results: Among 46 adult patients with congenital choledochal cyst,8 cases had carcinogenesis after operation,and the canceration rate was 17.4%.The age of the two groups was analyzed by independent sample t test,and the sex and abdominal pain were analyzed by chi-square test.Jaundice,abdominal mass,fever,nausea or vomiting,cholangitis,cholelithiasis,cholecystitis,history of biliary drainage,town / countryside,etc.reach(a conclusion):(1)the mean age of the canceration group and the non-cancerous group were significantly higher than that of the non-cancerous group,with statistical significance(2)the proportion of the history of biliary drainage in the cancerous group was higher than that in the non-cancerous group,and there was statistically significant difference between the canceration group and the non-cancerous group.(3)the proportion of patients with gallstone in cancer group was 17.4,which was higher than that in non-cancerous group,although there was no statistical difference(P0.057),but there was tendency;(4)gender,abdominal pain,jaundice,abdominal mass,fever,nausea or vomiting,cholangitis,cholelithiasis,cholecystitis,carcinogenesis of congenital choledochal cyst in urban / rural areas and adults had no statistical significance(P > 0.05).;Logistic regression analysis showed that age was an independent risk factor for carcinogenesis of congenital choledochal cyst in adults.The history of biliary drainage is not an independent risk factor for canceration of congenital choledochal cyst in adults.Conclusion: Age and history of biliary drainage are risk factors for carcinogenesis of congenital choledochal cyst in adults,and age is an independent influencing factor for carcinogenesis of congenital choledochal cyst in adults.Optimal timing of operation(childhood is the best time for surgery);Therefore,once there are choledochal cysts found in clinic,early surgical treatment should be performed to avoid palliative biliary drainage or partial cyst resection,to prevent carcinogenesis and to improve the quality of life.