Search citation statements
Paper Sections
Citation Types
Year Published
Publication Types
Relationship
Authors
Journals
Choledochal cysts are congenital cystic dilatations of the extrahepatic and/or intrahepatic bile ducts. Diagnosis and choice of treatment tactics for this pathology often cause difficulties. A case report of a choledochal cyst in a 2-year-old patient with symptoms of recurrent jaundice, cholangitis, and pancreatitis, which required laparoscopic cholecystostomy and cholangiography during preparation for radical surgery, was retrospectively analyzed. The child was re-admitted to the pediatric surgical department with complaints of hyperthermia up to 39°C, resumption of periodic abdominal pain, nausea, and increased icterus of the sclera and skin. Laboratory and ultrasound examination indicated biliary and pancreatic hypertension. Choledochal cyst, cholestasis syndrome, acute cholecystopancreatitis was diagnosed. Owing to the existing clinical symptoms and laboratory and ultrasound data, laparoscopic cholecystostomy was urgently performed. Against the background of conservative therapy, within 2 days after laparoscopic cholecystostomy, clinically, laboratory and according to control ultrasound examination, biliary and pancreatic hypertension were stopped. The child underwent cholangiography through a cholecystostomy without additional anesthesia, which revealed a fusiform dilatation of the common hepatic and bile ducts. After 2 weeks of drug treatment against the background of laparoscopic cholecystostomy, the child underwent excision of the common bile duct cyst, and cholecystectomy with hepatic enteroanastomosis on a Roux-en-Y loop. The postoperative period was smooth. No other complaints or complications were noted within 24 months. In the reported case, recurrent obstructive jaundice was caused by a choledochal cyst. Laparoscopic cholecystostomy enabled the quick and successful relief of biliary hypertension, preparation of the patient for radical surgical treatment, and safe informative cholangiography through cholecystostomy. Hepatic enteroanastomosis with a disconnected loop according to Roux-en-Y was an effective surgical treatment method for choledochal cyst.
Choledochal cysts are congenital cystic dilatations of the extrahepatic and/or intrahepatic bile ducts. Diagnosis and choice of treatment tactics for this pathology often cause difficulties. A case report of a choledochal cyst in a 2-year-old patient with symptoms of recurrent jaundice, cholangitis, and pancreatitis, which required laparoscopic cholecystostomy and cholangiography during preparation for radical surgery, was retrospectively analyzed. The child was re-admitted to the pediatric surgical department with complaints of hyperthermia up to 39°C, resumption of periodic abdominal pain, nausea, and increased icterus of the sclera and skin. Laboratory and ultrasound examination indicated biliary and pancreatic hypertension. Choledochal cyst, cholestasis syndrome, acute cholecystopancreatitis was diagnosed. Owing to the existing clinical symptoms and laboratory and ultrasound data, laparoscopic cholecystostomy was urgently performed. Against the background of conservative therapy, within 2 days after laparoscopic cholecystostomy, clinically, laboratory and according to control ultrasound examination, biliary and pancreatic hypertension were stopped. The child underwent cholangiography through a cholecystostomy without additional anesthesia, which revealed a fusiform dilatation of the common hepatic and bile ducts. After 2 weeks of drug treatment against the background of laparoscopic cholecystostomy, the child underwent excision of the common bile duct cyst, and cholecystectomy with hepatic enteroanastomosis on a Roux-en-Y loop. The postoperative period was smooth. No other complaints or complications were noted within 24 months. In the reported case, recurrent obstructive jaundice was caused by a choledochal cyst. Laparoscopic cholecystostomy enabled the quick and successful relief of biliary hypertension, preparation of the patient for radical surgical treatment, and safe informative cholangiography through cholecystostomy. Hepatic enteroanastomosis with a disconnected loop according to Roux-en-Y was an effective surgical treatment method for choledochal cyst.
Introduction. Cysts of the common bile duct or choledoch cysts (CC) are congenital cystic dilatation of the extrahepatic and / or intrahepatic bile ducts. The etiology is not fully clear, but it has been proven that abnormal pancreatobiliary anastomosis plays a major role in CC formation. Clinical manifestations range from prolonged jaundice in newborns to non-specific abdominal pains in older patients. Purpose. To study clinical manifestations of common bile duct cysts in children of different age, to define diagnostic criteria as well as to analyze outcomes after surgical treatment. Material and methods. In 2001-2019, 27 patients with chronic obstructive CC, aged from several days to 12 y.o., were treated in the Children’s City Multidisciplinary Clinical Specialized Center for High Medical Technologies of St. Petersburg. Most of them (16-59.2%) had CC of type IA by the Todani classification. Ultrasound examination and MRI cholangiography were used for diagnostics. Children with CC of type V (Caroli disease) required a specific approach to their treatment because of the combined malformations in kidneys (polycystic kidney disease); in 19 patients with CC of types I and IV the cystically altered choledoch was resected and hepaticojejunostomy was put on the loop by the P technique. Results. 19 patients were operated on. Good outcomes were in 15 cases. Underlying disease complications in the preoperative period were noted in 8 patients: pancreatitis in 5 patients, perforation of cysts with biliary peritonitis in 3 patients. In the postoperative period, 4 patients had complications: stenosis of the anastomosis in 1; portal hypertension in 1; 3 children developed cholangitis, 1 of them required surgical correction. Out of 5 patients with Caroli disease, 2 children died in the neonatal period, one because his parents refused of treatment. Two children aged 12 and 17 had liver and kidney transplantation. Conclusion. CC clinical manifestations are diverse; asymptomatic course can develop up to some age. Ultrasound and MRI cholangiography are main diagnostic tools. Resection of the cyst with hepaticojejunostomy on the loop by the P technique is a radical approach to the treatment and has good outcomes. Patients with Caroli disease require an individual approach.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.