Choledochal Cysts in Adults

Liu, Chi‐Leung; Fan, Sheung‐Tat; Lo, Chung‐Mau; Lam, Chi‐Ming; Poon, Ronnie Tung‐Ping; Wong, John

doi:10.1001/archsurg.137.4.465

Cited by 105 publications

(104 citation statements)

References 24 publications

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“…Type V choledochal cysts, also known as Caroli's disease represents multiple dilation of intrahepatic biliary ducts. 7 Lipsett et al 25 and Cho et al 26 mentioned complete excision of extrahepatic component of choledochal cyst combined with cholecystectomy, followed by Roux-en-Y biliary reconstruction as the treatment of choice for type I and IV choledochal cyst 14,254,5,35,36,46 And depending on cyst type (Todani type IV, V), further intervention may be necessary. [27][28][29] Cholecystectomy is carried out due to the high risk of associated gall bladder malignancy.…”

Section: Jcms Nepal 2017;13(1):174-8 Choledochal Cyst: Clinical Presementioning

confidence: 99%

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Choledochal Cyst: Their clinical presentation, diagnosis and treatment in central Nepal: a retrospective study

Kumar¹,

Jalan²,

Patowary³

2017

J Coll Med Sci-Nepal

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Background & Objectives:Choledochal cyst is a r ar e congenital malformation involving the cystic dilatation of intrahepatic and/ or extrahepatic bile duct .The estimated incidence is one in 1000 live birth in Asian population with female to male ratio 3:1. The objective of the study was to study the presentation, diagnosis, treatment and outcome of choledochal cyst in College of Medical Sciences, Bharatpur, Nepal Materials & Methods: A r etr ospective r eview of the r ecor ds of all the patients who were diagnosed as choledochal cyst and underwent medical or operative intervention in our hospital from January 2013-January 2015. Results: We analyzed ten cases of choledochal cyst. The condition commonly affected the age group of six to ten years with female preponderance (70%). Most common presenting symptom was pain abdomen (100%) and jaundice (50%). However classical triad of abdominal pain, jaundice, and an abdominal mass was not seen in any of the cases. Ultrasonography was diagnostic in all cases. Todani type I cyst was the most common type. Nine out of ten cases underwent complete cyst excision with cholecystectomy and Roux-en-Y hepaticojejunostomy without any major complication. Conclusion: Choledochal cyst is a clinical condition that is conveniently diagnosed on ultrasound and has a rewarding outcome if operated

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Section: Jcms Nepal 2017;13(1):174-8 Choledochal Cyst: Clinical Presementioning

confidence: 99%

“…[2][3][4] It has female preponderance and female: male ratio is 3:1. 5 Todani Type I cysts are the most common type and account for approximately 75% of patients. 6 The most accepted theory in pathogenesis of choledochal cyst is Babbitt's theory is associated with anomalous pancreaticobiliary duct junction (APBDJ).…”

Section: Introductionmentioning

confidence: 99%

Choledochal Cyst: Their clinical presentation, diagnosis and treatment in central Nepal: a retrospective study

Kumar¹,

Jalan²,

Patowary³

2017

J Coll Med Sci-Nepal

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“…After excluding tumors, stones, flogistic strictures, a rare cause of CBD dilatation may be identified in choledochal cysts, a heterogeneous group of congenital focal or multiple anomalous dilatations of the biliary tree, usually diagnosed in childhood but remaining undetected until adulthood in 25% of cases [33,34] . Although abdominal pain is the most frequent symptom in adult patients, non-specific symptoms are also reported and the cyst may be incidentally identified in patients undergoing radiologic evaluation for other clinical suspicions [35,36] .…”

Section: Causes Of Biliary Dilatationmentioning

confidence: 99%

Endoscopic ultrasound in common bile duct dilatation with normal liver enzymes

Angelis¹,

Marietti²,

Bruno³

et al. 2015

WJGE

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In recent years, the description of isolated bile duct dilatation has been increasingly observed in subjects with normal liver function tests and nonspecific abdominal symptoms, probably due to the widespread use of high-resolution imaging techniques. However, there is scant literature about the evolution of this condition and the impact of endoscopic ultrasound (EUS) in the diagnostic work up. When noninvasive imaging tests (transabdominal ultrasound, computed tomography or magnetic resonance cholangiopancreatography) fail to identify the cause of dilatation and clinical or biochemical alarm signs are absent, the probability of having biliary disease is considered low. In this setting, using EUS, the presence of pathologic findings (choledocholithiasis, strictures, chronic pancreatitis, ampullary or pancreatic tumors, cholangiocarcinoma), not always with a benign course, has been observed. The aim of this review has been to evaluate the prevalence of disease among nonjaundiced patients without signs of cytolysis and/or cholestasis and the assessment of EUS yield. Data point out to a promising role of EUS in the identification of a potential biliary pathology. EUS is a low invasive technique, with high accuracy, that could play a double cost-effective role: identifying pathologic conditions with dismal prognosis, in asymptomatic patients with negative prior imaging tests, and excluding pathologic conditions and further follow-up in healthy subjects. Core tip: Common bile duct dilatation, often without identified causes, in subjects with normal liver function tests and nonspecific abdominal symptoms, and absence of lesions on prior noninvasive imaging tests, is increasingly found in the clinical practice. Since the clinical suspicion for biliary pathology in that setting is usually low, and there are limited literature data, this condition is ignored. However, recent evidences show the existence of pathologies among these patients, often with a non-benign course. In this scenario, endoscopic

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“…16,17 Bilateral involvements with evidence of biliary cirrhosis have liver transplantation as the only solution. Drainage of the extrahepatic component alone in the presence of intrahepatic duct cysts has a high incidence of malignancy.…”

Section: Management Optionsmentioning

confidence: 99%