{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T10:59:55Z","timestamp":1793271595408,"version":"4.5.0"},"reference-count":23,"publisher":"Wiley","license":[{"start":{"date-parts":[[2015,1,1]],"date-time":"2015-01-01T00:00:00Z","timestamp":1420070400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gastroenterology Research and Practice"],"published-print":{"date-parts":[[2015]]},"abstract":"<jats:p><jats:italic>Background<\/jats:italic>. Our purpose was to investigate the association between the surgical approach for Todani type IV cysts and subsequent malignancy rate.<jats:italic>Methods<\/jats:italic>. The records of patients who received cyst excision from 1994 to 2013 were analyzed retrospectively for the following data: demographics, presenting symptoms, postoperative outcomes, malignant transformation, and follow-up reexaminations, including imaging, laboratory, and tumor marker tests.<jats:italic>Results<\/jats:italic>. Seven of the 196 patients initially treated at our hospital developed postoperative biliary malignancy, and the surgical approaches were extrahepatic bile duct cyst resection combined with hilar cholangioplasty and Roux-en-Y cystojejunostomy (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>5<\/mml:mn><\/mml:math>), and intra- and extrahepatic bile duct cyst resection and Roux-en-Y hepaticojejunostomy (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>2<\/mml:mn><\/mml:math>). The overall malignancy rate was 3.6% (7\/196). Forty-eight patients initially treated at other hospitals developed malignancy postoperatively: 15 (31.2%) remained untreated and 33 (68.8%) had undergone incomplete resection procedures. Because Todani type IV cysts were seen in 268 patients, the postoperative malignancy rate of this group of patients was 12.3% (33\/268).<jats:italic>Conclusions<\/jats:italic>. Radical resection of both intra- and extrahepatic cysts combined with hepatic resection and Roux-en-Y hepaticojejunostomy is associated with a reduced risk of subsequent cancer development. Procedures in which radical cyst excision is not performed are associated with a greater risk of subsequent malignancy.<\/jats:p>","DOI":"10.1155\/2015\/417685","type":"journal-article","created":{"date-parts":[[2015,7,9]],"date-time":"2015-07-09T19:25:59Z","timestamp":1436469959000},"page":"1-5","source":"Crossref","is-referenced-by-count":9,"title":["Role of the Surgical Method in Development of Postoperative Cholangiocarcinoma in Todani Type IV Bile Duct Cysts"],"prefix":"10.1155","volume":"2015","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3821-5747","authenticated-orcid":true,"given":"Hong-tian","family":"Xia","sequence":"first","affiliation":[{"name":"Hospital and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing 100853, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Yang","sequence":"additional","affiliation":[{"name":"Hospital and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing 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