Treatment Strategy for Adult Congenital Biliary Dilation

Beijing Tsinghua Chang Gung Hospital234 enrolled

Overview

The management of congenital biliary dilations (CBDs), including choledochal cysts, represents one of the most challenging areas in hepatobiliary surgery due to their potential implications for long-term morbidity and malignant transformation. While CBDs have a relatively low incidence in Western populations (1/150,000-1/100,000), the prevalence is notably higher in Asian countries (1/1,000), making it a significant global health concern. Although complete surgical resection remains the standard of care, the optimal extent of resection and reconstruction strategy, particularly for complex disease patterns, continues to be debated. To address these challenges, the current study proposes a novel surgery-oriented classification system for adult CBD based on the analysis of 234 consecutive cases.

Study Type

OBSERVATIONAL

Enrollment

234

Conditions

Congenital Biliary Dilation

Interventions

hepatectomy、liver transplantation、hepaticojejunostomyPROCEDURE

resection of the diseased bile duct, elimination of secondary lesions, and restoration of biliary-enteric continuity.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria ： 1. Age: Adults (≥18 years). 2. Study population: Consecutive patients treated at Beijing Tsinghua Changgung Hospital. 3. Time frame: Underwent surgical treatment between November 2014 and October 2024. 4. Condition/Procedure: Underwent surgical treatment for common bile duct (CBD) diseases. 5. Diagnostic confirmation: Presence, location, and extent of CBD dilatation were diagnosed by preoperative imaging/radiology, and confirmed intraoperatively. Exclusion Criteria ： 1.Secondary biliary dilatation due to proximal obstruction, including intrahepatic and/or extrahepatic bile duct dilatation caused by proximal biliary obstruction, such as: 1. benign stricture, 2. malignant stricture, 3. obstructive stones.

Locations (1)

Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, Key Laboratory of Digital Intelligence Hepatology, Ministry of Education, School of Clinical Medicine, Tsinghua University, Beijing, China

Beijing, Beijing Municipality, China

Outcomes

Primary Outcomes

The modified Mayo Clinic score for CBD

Patients were stratified into excellent, good, fair, and poor categories based on established criteria

Time frame: Last follow-up time (assessed up to 10 year)

Secondary Outcomes

perioperative complications

graded according to the Clavien-Dindo classification,23 specific complications assessed using the International Study Group of Liver Surgery (ISGLS) criteria, including posthepatectomy liver dysfunction, bile leakage, and pancreatic leakage24-26

Time frame: Perioperative period（Within 3 months after surgery）

long-term disease-free survival

long-term disease-free survival defined as the interval from surgery to the first occurrence of any of the following events: cholangitis episode, bile stone formation, cholangiocarcinoma development, any long-term complications related to biliary surgery, or death from any cause.

Time frame: Last follow-up time (assessed up to 10 year)