Choledochal cyst in childhood: review of 30 cases

Abstract

We observed a marked female predominance (73.4% of cases), the diagnosis being made in the first decade of life in 90% of patients. The most prevalent clinical manifestation was jaundice (70% of cases) and the classic triad of choledochal cyst was not observed. Abdominal ultrasound was the first imaging examination performed, with a sensitivity of 56.6%, with diagnostic definition in 17 children. Two patients (6.6%) had prenatal diagnosis. All patients underwent surgical treatment, cyst resection with Roux-en-Y hepaticojejunostomy being performed in 80% of cases. The incidence of postoperative complications was 13.3% and the mortality rate was 6.6%, ie two patients were diagnosed with Caroli's disease. ConclusionConclusion Conclusion Conclusion Conclusion: The non-observance of the classic triad of choledochal cyst suggests that its incidence is lower than that reported in the medical literature. The surgical treatment of choledochal cysts, with resection and bilioenteric anastomosis, is safe even for small children.

Nonneoplastic lesions of the pancreas: retrospective analysis of 20 cases

“…Koledok kistleri, intra ve/ veya ekstrahepatik safra duktuslarının dilatasyonu ile seyreden nadir görülen konjenital anomalidir. [25] Mikroskopik olarak epitelde kesintili destrüksiyon ve inflamasyon görülür. Danielle Nunes Forny [25] ve arkadaşlarının yapmış olduğu çocukluk çağında saptanan 30 koledok kist olgusunun retrospektif analizinde yapılan karaciğer biyopsilerinin %45.5 'inde fibrozis dikkati çekmektedir.…”

Choledochal cyst in the pediatric population: experience of 13 laparoscopic procedures in two years at a single institution

“…Helicobacter pylori gastritis and the patient displayed clinical improvement after treatment. Currently, the investigation begins with ultrasonography, which presents high sensitivity for diagnosis of diseases of the biliary tract 4 . Prenatal diagnosis has been described, in some cases, as of the 15th week of gestation and has become increasingly frequent in our environment 2 .…”

“…Noninvasive tests to define the anatomy of the biliary tree include computed tomography (sensitivity and specificity of about 90%), hepatic-biliary scintigraphy with technetium-99 and magnetic resonance imaging (70 to 100% sensitivity and 90 to 100% specificity). All these methods can be used as a diagnostic approach, magnetic resonance imaging being the gold standard 1,4 . All patients in this sample were submitted to ultrasonography and magnetic resonance imaging for diagnostic confirmation.…”

“…Regarding follow-up, some studies have shown that even patients with prenatal diagnosis and surgery in the first year of life present changes in liver biopsies as a result of biliary obstruction, with ductal proliferation, fibrosis and even cirrhosis 4 . Malignant alterations of the bile duct epithelium may occur even after removal of the cyst and, therefore, patients need to be followed and observed for symptoms' recurrence.…”

“…They may manifest only in adulthood, but about 60% of cases are diagnosed in the first decade of life 4 . There are several etiological explanations, but the most accepted is the Babbitt Theory, which attributes the formation of the cysts to an abnormality at the junction of the pancreatic duct with the common bile duct, outside the Vater ampulla, resulting in a common long canal, which allows the reflux of pancreatic juice into the bile duct 5 .…”