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Congenital bile duct cyst (BDC) is a more indolent disease in children compared to adults, except for Todani type IV-A BDC : results of the European multicenter study of the French Surgical Association

Mehdi Ouaissi, Reza Kianmanesh, Emilia Ragot, Jacques Belghiti, Barbara Wildhaber, Gennaro Nuzzo, Remi Dubois, Yann Revillon, Daniel Cherqui, Daniel Azoulay, et al.
(2016) HPB. 18(6). p.529-539
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Abstract
Aim: To compare clinical presentation, operative management and short- and long-term outcomes of congenital bile duct cysts (BDC) in adults with children. Methods: Retrospective multi-institutional Association Francaise de Chirurgie study of Todani types I+IVB and IVA BDC. Results: During the 37-year period to 2011, 33 centers included 314 patients (98 children; 216 adults). The adult population included more high-risk patients, with more active, more frequent prior treatment (47.7% vs 11.2%; p < 0.0001), more complicated presentation (50.5% vs 35.7%; p = 0.015), more synchronous biliary cancer (11.6% vs 0%; p = 0.0118) and more major surgery (23.6% vs 2%; p < 0.0001), but this latter feature was only true for type I+IVB BDC. Compared to children, the postoperative morbidity (48.1% vs 20.4%; p < 0.0001), the need for repeat procedures and the status at follow-up were worse in adults (27% vs 8.8%; p = 0.0009). However, severe postoperative morbidity and fair or poor status at follow-up were not statistically different for type IVA BDC, irrespective of patients' age. Synchronous cancer, prior HBP surgery and Todani type IVA BDC were independent predictive factors of poor or fair long-term outcome. Conclusion: BDC is a more indolent disease in children compared to adults, except for Todani type IV-A BDC.
Keywords
CHOLEDOCHAL-CYSTS, MANAGEMENT, CLASSIFICATION, COMPLICATIONS, INVOLVEMENT, EXPERIENCE, CHALLENGE, AGE

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MLA
Ouaissi, Mehdi, et al. “Congenital Bile Duct Cyst (BDC) Is a More Indolent Disease in Children Compared to Adults, except for Todani Type IV-A BDC : Results of the European Multicenter Study of the French Surgical Association.” HPB, vol. 18, no. 6, 2016, pp. 529–39, doi:10.1016/j.hpb.2016.04.005.
APA
Ouaissi, M., Kianmanesh, R., Ragot, E., Belghiti, J., Wildhaber, B., Nuzzo, G., … Vanlander, A. (2016). Congenital bile duct cyst (BDC) is a more indolent disease in children compared to adults, except for Todani type IV-A BDC : results of the European multicenter study of the French Surgical Association. HPB, 18(6), 529–539. https://doi.org/10.1016/j.hpb.2016.04.005
Chicago author-date
Ouaissi, Mehdi, Reza Kianmanesh, Emilia Ragot, Jacques Belghiti, Barbara Wildhaber, Gennaro Nuzzo, Remi Dubois, et al. 2016. “Congenital Bile Duct Cyst (BDC) Is a More Indolent Disease in Children Compared to Adults, except for Todani Type IV-A BDC : Results of the European Multicenter Study of the French Surgical Association.” HPB 18 (6): 529–39. https://doi.org/10.1016/j.hpb.2016.04.005.
Chicago author-date (all authors)
Ouaissi, Mehdi, Reza Kianmanesh, Emilia Ragot, Jacques Belghiti, Barbara Wildhaber, Gennaro Nuzzo, Remi Dubois, Yann Revillon, Daniel Cherqui, Daniel Azoulay, Chritian Letoublon, François-René Pruvot, Adeline Roux, Jean-Yves Mabrut, Jean-François Gigot, on behalf of the French Surgical Association, Roberto Troisi, and Aude Vanlander. 2016. “Congenital Bile Duct Cyst (BDC) Is a More Indolent Disease in Children Compared to Adults, except for Todani Type IV-A BDC : Results of the European Multicenter Study of the French Surgical Association.” HPB 18 (6): 529–539. doi:10.1016/j.hpb.2016.04.005.
Vancouver
1.
Ouaissi M, Kianmanesh R, Ragot E, Belghiti J, Wildhaber B, Nuzzo G, et al. Congenital bile duct cyst (BDC) is a more indolent disease in children compared to adults, except for Todani type IV-A BDC : results of the European multicenter study of the French Surgical Association. HPB. 2016;18(6):529–39.
IEEE
[1]
M. Ouaissi et al., “Congenital bile duct cyst (BDC) is a more indolent disease in children compared to adults, except for Todani type IV-A BDC : results of the European multicenter study of the French Surgical Association,” HPB, vol. 18, no. 6, pp. 529–539, 2016.
@article{8514892,
  abstract     = {{Aim: To compare clinical presentation, operative management and short- and long-term outcomes of congenital bile duct cysts (BDC) in adults with children. 
Methods: Retrospective multi-institutional Association Francaise de Chirurgie study of Todani types I+IVB and IVA BDC. 
Results: During the 37-year period to 2011, 33 centers included 314 patients (98 children; 216 adults). The adult population included more high-risk patients, with more active, more frequent prior treatment (47.7% vs 11.2%; p < 0.0001), more complicated presentation (50.5% vs 35.7%; p = 0.015), more synchronous biliary cancer (11.6% vs 0%; p = 0.0118) and more major surgery (23.6% vs 2%; p < 0.0001), but this latter feature was only true for type I+IVB BDC. Compared to children, the postoperative morbidity (48.1% vs 20.4%; p < 0.0001), the need for repeat procedures and the status at follow-up were worse in adults (27% vs 8.8%; p = 0.0009). However, severe postoperative morbidity and fair or poor status at follow-up were not statistically different for type IVA BDC, irrespective of patients' age. Synchronous cancer, prior HBP surgery and Todani type IVA BDC were independent predictive factors of poor or fair long-term outcome. 
Conclusion: BDC is a more indolent disease in children compared to adults, except for Todani type IV-A BDC.}},
  author       = {{Ouaissi, Mehdi and Kianmanesh, Reza and Ragot, Emilia and Belghiti, Jacques and Wildhaber, Barbara and Nuzzo, Gennaro and Dubois, Remi and Revillon, Yann and Cherqui, Daniel and Azoulay, Daniel and Letoublon, Chritian and Pruvot, François-René and Roux, Adeline and Mabrut, Jean-Yves and Gigot, Jean-François and French Surgical Association, on behalf of the and Troisi, Roberto and Vanlander, Aude}},
  issn         = {{1365-182X}},
  journal      = {{HPB}},
  keywords     = {{CHOLEDOCHAL-CYSTS,MANAGEMENT,CLASSIFICATION,COMPLICATIONS,INVOLVEMENT,EXPERIENCE,CHALLENGE,AGE}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{529--539}},
  title        = {{Congenital bile duct cyst (BDC) is a more indolent disease in children compared to adults, except for Todani type IV-A BDC : results of the European multicenter study of the French Surgical Association}},
  url          = {{http://dx.doi.org/10.1016/j.hpb.2016.04.005}},
  volume       = {{18}},
  year         = {{2016}},
}
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