J Korean Med Sci.  2004 Dec;19(6):842-847. 10.3346/jkms.2004.19.6.842.

Experience of Congenital Choledochal Cyst in Adults: Treatment, Surgical Procedures and Clinical Outcome in the Second Affiliated Hospital of Harbin Medical University

• Zheng LX
• Jia HB
• Wu DQ
• Shang H
• Zhong XY
• Wang QS
• Zhou WX
• Sun ZH

• KMID: 1778566
• DOI: http://doi.org/10.3346/jkms.2004.19.6.842

Abstract

This study was undertaken to analyze and evaluate the diagnosis and principal treatment methods for congenital choledochal cyst, focusing on various surgical procedures and clinical outcome. A comprehensive, retrospective study was conducted on 72 adult patients who presented with choledochal cyst from 1985 to 2002. Surgical procedures were cyst excision with hepaticojejunostomy in 25 cases for type I or type IV-B, extrahepatic cyst excision with hepaticojejunostomy in 8 cases for type IV-A, extrahepatic cyst excision with modified hepaticojejunostomy in 2 cases for type IV-B, non-cyst excision with or without hepaticojejunostomy in 27 cases for types I, II, IV-A, IV-B. The early postoperative morbidity and mortality rate were 16.1% (9/62) and 6.5% (4/62) respectively, and the complication rate related to surgical procedure was 30.6% (19/62). The incidence of cholangiocarcinoma with non-cyst excision or non-operated congenital choledochal cyst was 10.8% (4/37). One patient died of primary hepatocellular carcinoma after cyst excision with hepatojejunostomy. In conclusion, our results showed that complete exci-sion of choledochal cyst for types I, II, and IV-B and complete excision of extra-hepatic choledochal cyst from the hepatic hilum in type IV-A with hepaticojejunostomy or modified hepaticojejunostomy are the treatment of choice for choledochal cyst in adult patients.

Keyword

Choledochal Cyst; Surgical Procedures, Operative; Biliary Tract; Anastomosis Roux-en-Y; Adult; Disease Management

MeSH Terms

Academic Medical Centers/trends
Adolescent
Adult
Choledochal Cyst/*epidemiology/*surgery
Female
Hepatectomy/*methods/*statistics & numerical data
Humans
Jejunostomy/*methods/*statistics & numerical data
Korea/epidemiology
Male
Middle Aged
Postoperative Complications/*epidemiology
Retrospective Studies
Treatment Outcome

Figure

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  Fig. 1 Cyst excision with hepatojejunostomy.

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  Fig. 2 Cyst excision with modified hepatojejunostomy.

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  Fig. 3 Cyst excision, jejunal segment interposition with hepatojejunostomy.

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