Korean J Radiol.  2012 Feb;13(Suppl 1):S112-S116. 10.3348/kjr.2012.13.S1.S112.

Is Preoperative Subclassification of Type I Choledochal Cyst Necessary?

• Jung K
• Han HS
• Cho JY
• Yoon YS
• Hwang DW

• KMID: 1372876
• DOI: http://doi.org/10.3348/kjr.2012.13.S1.S112

Abstract

OBJECTIVE
The aim of this study was to evaluate the frequency of postoperative biliary stricture and its risk factors in patients undergoing surgery for type I choledochal cyst.
MATERIALS AND METHODS
A total of 35 patients with type I choledochal cyst underwent laparoscopic cyst excision and Roux-en-Y hepaticojejunostomy between August 2004 and August 2011. Their medical records and radiologic images (including endoscopic retrograde cholangiopancreatography, magnetic resonance cholangiopancreatography, pancreatobiliary computed tomography, or ultrasound) were retrospectively analyzed to evaluate the frequency of postoperative biliary stricture and its risk factors.
RESULTS
Postoperative biliary stricture was found in 10 (28.6%) of 35 patients. It developed more frequently in patients with type Ia choledochal cyst (53.8%, 7 of 13 patients) than in patients with type Ic choledochal cyst (13.6%, 3 of 22 patients), which was statistically significant (p = 0.011). There were no significant associations between other factors and postoperative biliary stricture.
CONCLUSION
Type Ia is a risk factor of postoperative anastomotic stricture. Therefore, preoperative radiologic subclassification of type Ia and Ic may be useful in predicting postoperative outcomes of choledochal cysts.

Keyword

Choledochal cyst; Biliary stricture; Todani's classification; Type Ia; Type Ic

MeSH Terms

Adolescent
Adult
Anastomosis, Roux-en-Y
Biliary Tract Surgical Procedures/methods
Chi-Square Distribution
Child
Child, Preschool
Cholangiopancreatography, Endoscopic Retrograde
Cholangiopancreatography, Magnetic Resonance
Choledochal Cyst/*pathology/*surgery
Female
Humans
Infant
Jejunostomy/methods
Laparoscopy/*methods
Male
Middle Aged
Postoperative Complications/*diagnosis
Statistics, Nonparametric
Tomography, X-Ray Computed
Treatment Outcome
Ultrasonography/methods

Figure

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  Fig. 1 Magnetic resonance cholangiopancreatography image of type Ia choledochal cyst.

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  Fig. 2 Magnetic resonance cholangiopancreatography image of type Ic choledochal cyst.

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