Complications after cyst excision with hepaticoenterostomy for choledochal cysts and their surgical management in children versus adults

Yamataka, Atsuyuki; Ohshiro, Kiyohiko; Okada, Yasuhiro; Hosoda, Yataro; Fujiwara, Toshio; Kohno, Sumio; Sunagawa, Masakatsu; Futagawa, Shunji; Sakakibara, Noburu; Miyano, Takeshi

doi:10.1016/s0022-3468(97)90407-3

Cited by 148 publications

(133 citation statements)

References 16 publications

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“…Other complications described are cholangitis, peptic ulcer, fat malabsorption, diarrhea, and malnutrition [1]. Long-term follow-up studies after choledochal cyst excision hepaticojejunostomy have shown a significant incidence of late complications requiring reoperation, including anastomotic stricture at the hepaticojejunostomy [2][3][4]. To prevent a stricture, a wide hilar hepaticojejunostomy extending into the left hepatic duct is advocated [19].…”

Section: Discussionmentioning

confidence: 99%

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Hepaticoduodenostomy for Biliary Reconstruction After Surgical Resection of Choledochal Cyst: a 25-Year Experience

Patil

Kanetkar²,

Talpallikar

2012

Indian J Surg

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We reviewed our experience of hepaticoduodenostomy done for choledochal cyst from 1982 to 2007 at our center. The aim of the study was to evaluate the efficacy of hepaticoduodenostomy as a mode of biliary reconstruction after surgical resection of choledochal cyst, to look for any complications associated with hepaticoduodenostomy, with review of the literature. A total of 56 patients underwent hepaticoduodenostomy after surgical resection of choledochal cyst, of which 54 patients underwent primary cyst excision with hepaticoduodenostomy and 2 patients underwent redo surgery (hepaticoduodenostomy). Most of the patients had an uneventful postoperative recovery. Early complications were biliary leak in three patients which subsided on conservative treatment. Long-term complication was seen in only one patient who developed anastomotic stricture 18 years after primary resection of choledochal cyst and hepaticoduodenostomy. Hepaticoduodenostomy is a relatively safe procedure with very low complication rates. It requires a single anastomosis and is simple to perform.

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Section: Discussionmentioning

confidence: 99%

“…Long-term follow-up has shown a significant incidence of late complications, namely anastomotic stricture, cholangitis, peptic ulcer, fat malabsorption, diarrhea, and malnutrition [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Hepaticoduodenostomy for Biliary Reconstruction After Surgical Resection of Choledochal Cyst: a 25-Year Experience

Patil

Kanetkar²,

Talpallikar

2012

Indian J Surg

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“…However, even hepaticojejunostomy, which successfully solves the problem of extrahepatic biliary obstruction, in 7%-38% of patients can result in anastomotic strictures which require subsequent percutaneous, transhepatic or endoscopic dilation. Further complications include ascending colonization of normally sterile bile ducts by enteral Escherichia coli bacteria, which leads to recurrent cholangitis, biliary lithiasis, pancreatitis, liver failure and cholangiocarcinoma (in 9%-28% of cases 7 ), or even the formation of peptic ulcers [7][8][9][10][11][12] .…”

Section: Discussionmentioning

confidence: 99%

What is the Right Therapeutic Approach to Biliary Choledochal Cyst?

Marušić

Dominković²,

Halle

et al. 2017

acc

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SUMMARY -We report a case of biliary cyst type II which, independently of its a priori benign nature, caused numerous complications such as recurrent cholangitis and pancreatitis, as well as subsequent hepatic fi brosis and the potential danger of choledochocele perforation. Although they are benign, biliary/choledochal cysts can cause numerous disorders such as cholestasis, leading to cholangitis and pancreatitis and biliary sepsis, and due to chronic infl ammation of the biliary system even cholangiocarcinogenesis. Our fi ndings showed that sometimes this type of biliary cyst (according to the available literature the rarest and most benign type), as well as type I cyst, should undergo timely radical excision. In our patient, timely choledochocele resection would have certainly contributed to the reduction of subsequent complications, as well as to obviating repeated invasive diagnostic and surgical procedures.

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“…Pathologic complications include biliary obstruction, cholangitis, hepatic abscess, rupture, or development of cancer. Cholelithiasis due to choledochal cysts is unusual [2,9] . Clinical manifestations are nonspecific and variable.…”

Section: Discussionmentioning

confidence: 99%

Choledochal cysts in pregnancy: Case management and literature review

Zheng²,

Wang³

et al. 2004

WJG

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AIM:To evaluate the diagnosis, management principles and long-term results of congenital choledochal cysts in pregnancy. METHODS:Three adult patients were diagnosed as choledochal cysts in pregnancy from 1986 to 1989 and their long-term results were evaluated. RESULTS:The first patient had a Roux-en-Y cystojejunostomy with T-tube external drainage and died of septic shock and multi-organ failure 25 d after operation. In the second patient, 4 wk after percutaneous trans-choledochal cyst was drained externally with a catheter under US guidance, four weeks later the patient delivered vaginally, and had a cysto-jejunostomy 3 mo after delivery, and lived well without any complications for 15 years after operation. The third patient received Roux-en-Y cysto-jejunostomy after a vertex delivery by induced labor at 28 wk gestation, and demonstrated repetitively intermittent retrograde cholangitis within 10 years, and then died of well-differentiated congenital cholangioadenocarcinoma one month after reoperation with exploratory biopsy at the age of 36. CONCLUSION:More conservative approaches such as external drainage of choledochal cyst should be considered for pregnant patients with high risk, complete excision of choledochal cyst during hepaticojejunostomy or modified hepaticojejunostomy is highly recommended at the optimal time.Wu DQ, Zheng LX, Wang QS, Tan WH, Hu SJ, Li PL. Choledochal cysts in pregnancy: Case management and literature review.

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Complications after cyst excision with hepaticoenterostomy for choledochal cysts and their surgical management in children versus adults

Cited by 148 publications

References 16 publications

Hepaticoduodenostomy for Biliary Reconstruction After Surgical Resection of Choledochal Cyst: a 25-Year Experience

Hepaticoduodenostomy for Biliary Reconstruction After Surgical Resection of Choledochal Cyst: a 25-Year Experience

What is the Right Therapeutic Approach to Biliary Choledochal Cyst?

Choledochal cysts in pregnancy: Case management and literature review

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