By Charles Robert Anderson; Center of Military History

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Choledochal cyst disease in children and adults: a 30-year single-institution experience. J Am Coll Surg. 2008;206(5):1000–5. 34. Mabrut JY, Bozio G, Hubert C, et al. Management of congenital bile duct cysts. Dig Surg. 2010;27(1):12–8. 35. Yamaguchi M. Congenital choledochal cyst. Analysis of 1433 patients in the Japanese literature. Am J Surg. 1980;140(5): 653–7. 36. Todani T, Watanabe Y, Toki A, et al. Carcinoma related to choledochal cysts with internal drainage operations. Surg Gynecol Obstet.

The incidence of CC is also higher in Asians with bile-duct cysts, at approximately 18 %, with the US incidence closer to 6 % [19, 33–36]. Patients with bile-duct cysts are reported to have at least 10- to 50-fold increased risk of developing CC compared with the general population [20, 32, 37]. 7 % in the first decade of life to >14 % after the age of 20 [38]. The average age at malignancy detection has been reported to be 32 years, which is younger than the age at presentation of CC in the general population [32, 36].

9. Alvaro D, Crocetti E, Ferretti S, et al. Descriptive epidemiology of cholangiocarcinoma in Italy. Dig Liver Dis. 2010;42(7):490–5. 10. El-Serag HB, Engels EA, Landgren O, et al. S. veterans. Hepatology. 2009;49(1):116–23. 11. Erichsen R, Jepsen P, Vilstrup H, et al. Incidence and prognosis of cholangiocarcinoma in Danish patients with and without inflammatory bowel disease: a national cohort study, 1978–2003. Eur J Epidemiol. 2009;24(9):513–20. 12. Hoblinger A, Grunhage F, Sauerbruch T, et al.

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