BackgroundThis 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.MethodsWe 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.ResultsThe 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.ConclusionAlthough the long‐term prognosis is excellent with complete cyst excision and hepaticojejunostomy, we emphasize the importance of long‐term follow‐up.

中文翻译：

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儿科患者先天性胆管扩张的早期和晚期结果

背景本研究旨在通过回顾过去 40 年的病例，揭示先天性胆道扩张症 (CBD) 术后早期和晚期并发症及结局。方法我们回顾性评估 59 例接受根治性手术的 CBD 患者的并发症和结局。记录。早期并发症定义为初次手术后 5 年内需要治疗的并发症。晚期并发症定义为5年后接受治疗的并发症。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 3 名患者接受了胆囊十二指肠吻合术，1 名患者接受了肝十二指肠吻合术，但所有患者均在中位 12.5 年后转为肝空肠吻合术。一名患者患有同时性胆道癌并接受了胰十二指肠切除术。 7 名患者出现早期并发症，共 10 起事件（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). 9 名患者出现晚期并发症，共 12 起事件（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；胰腺结石病，n= 1).三名肝内胆管结石患者中的两名接受了内窥镜治疗无效的肝切除术。两名患者分别于上次手术后 34 和 13 年发展为非同步性胆道癌；两人最终都死于癌症。只有 35 名患者（61.4%）接受了随访检查。共有11名女性患者（45.8%）最终结婚，并全部成功生育。结论虽然完全囊肿切除和肝空肠吻合术的长期预后良好，但我们强调长期随访的重要性。