Ann Surg Treat Res.  2024 Apr;106(4):225-230. 10.4174/astr.2024.106.4.225.

Clinical characteristics of choledochal cysts with intrahepatic bile duct dilatations: an observational study

• Chen K
• Zhang S
• Cai D
• Zhang Y
• Jin Y
• Luo W
• Huang Z
• Hu D
• Gao Z

• KMID: 2554482
• DOI: http://doi.org/10.4174/astr.2024.106.4.225

Abstract

Purpose
Whether a dilated intrahepatic bile duct (IHBD) has any effect on the prognosis of choledochal cyst (CC) remains controversial. We aimed to summarize the clinical characteristics and prognosis of CC with IHBD dilatation.
Methods
One hundred ninety-two children diagnosed with CC were identified, including 127 without IHBD dilatation (group A) and 65 with IHBD dilatation (group B). A retrospective analysis was performed to explore the clinical characteristics and prognosis of CC with IHBD dilatation based on clinical indices, symptoms, and complications.
Results
Compared with group A, incidences of jaundice and fever were higher in group B (P = 0.010 and P = 0.033). Preoperative total bilirubin, direct bilirubin, and indirect bilirubin were increased in group B compared to group A (P = 0.005, P < 0.001, and P = 0.014), as were preoperative ALT, AST, γ-GT, and total bile acid (P = 0.006, P = 0.025, P < 0.001, and P = 0.024). The risk of liver fibrosis or cirrhosis was significantly increased for group B compared with group A (P = 0.012) and also occurred earlier in group B (P = 0.006). In the dilated IHBDs, 95.4% (62 of 65) recovered to normal, and more than half of dilated IHBDs (37 of 65) recovered to normal in 1 week.
Conclusion
Most IHBDs can recover to normal postoperatively in a short time, and proactive treatment is recommended for CC patients with IHBD dilatation for significant abnormal liver functions.

Keyword

Choledochal cyst; Dilatation; Extrahepatic bile ducts; Intrahepatic bile ducts

Figure

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  Fig. 1 Prognostic analyses of choledochal cyst patients with or without intrahepatic bile duct dilatation. Kaplan-Meier analysis of liver fibrosis- or cirrhosis-free survival for group A (high) and group B (low) was analyzed. Log-rank test was used.

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  Fig. 2 Preoperative (A) and postoperative (B) magnetic resonance cholangiopancreatography images of a patient with intrahepatic bile duct (IHBD) dilatation. The images were gained on May 30, 2017 and May 12, 2020, respectively. The red arrowheads point to the IHBD.

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