Potential Risk Factors and Prognostic Evaluation of Malignant Changes Following Congenital Choledochal Cyst: a Retrospective Analysis

Congenital choledochal cyst (CCC) is a congenital anomaly of the biliary duct with a tendency for malignant evolution. This study aimed to investigate the potential risk factors involved in the malignant transformation of these cysts and to elucidate the survival status of patients who subsequently developed malignancy. One hundred and fifty patients were involved in the study. They were divided into two groups; people in group A had malignancy, while people in group B did not. Of the total 150 patients, 15 (10%) developed malignancy. On univariate analysis, significant differences were found between the two groups, showing an increasing risk with older age (p = 0.003), presence of jaundice (p = 0.000) and biliary calculi (p = 0.000), and elevated conjugated bilirubin (CB), alkaline phosphatase (ALP), and γ-glutamyl transpeptidase levels (p = 0.005, 0.020, 0.021). On logistic regression analysis, only older age (p = 0.036), presence of biliary calculi (p = 0.003), and elevated levels of CB and ALP were identified as significant factors (p = 0.000, 0.039). In group A, the median overall survival time was 28.8 ± 8.1 months (95% confidence interval 12.9–44.7). In summary, older age, presence of biliary calculi, and elevated levels of CB and ALP are important indicators of the potential malignant transformation of CCC. Actively treating patients with biliary obstruction and impaired liver function are effective management methods for patients diagnosed with CCC.