Congenital Cystic Dilatation of the Common Bile Duct

Keeley, John L.

doi:10.1001/archsurg.1948.01240010516005

Cited by 23 publications

(4 citation statements)

References 5 publications

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“…It occurred in a man aged 30 and arose from the cyst wall. The cyst contained a number of gall stones, this being an uncomimon occurrence in choledochal cyst (Keeley, 1948). The tumour was a squamous cell carcinoma and was probably similar in origin to those sometimes seen in the gall bladder in association with calculi, though the age and sex of the patient suggest that other factors may also have been involved.…”

Section: ) D)extermentioning

confidence: 82%

Choledochal Cyst with Carcinoma of the Intrahepatic Bile Ducts and Pancreatic Ducts

Dexter¹

1957

Br J Cancer

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Section: ) D)extermentioning

confidence: 82%

Choledochal Cyst with Carcinoma of the Intrahepatic Bile Ducts and Pancreatic Ducts

Dexter¹

1957

Br J Cancer

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“…Cystic choledochal dilation can be diagnosed in the early stages of life [7,10,11] as well as in adults [2][3][4][5]12]. Of all the diagnostic procedures, abdominal sonography has been the most useful [4,5,13].…”

Section: Discussionmentioning

confidence: 99%

“…The operation with the best results is cysto-jejunal diversion (choledocho-cysto-jejunostomy) [11]. This operation was mod-ified to improve biliary drainage by resecting most of the cyst and anastomosing the sectioned surface in contact with the hepatic choledochus to the end of the Roux-en-Y loop [2,[5][6][7][8].…”

Section: Discussionmentioning

confidence: 99%

Choledochal cyst resection and reconstruction by biliary‐jejuno‐duodenal diversion

et al. 1989

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From January, 1983 to December, 1986, a total of 9 patients, ranging in age from 2 years and 4 months to 36 years, with choledochal cysts were treated. Symptoms were right upper quadrant pain (n = 9), ascending cholangitis (n = 7), and jaundice (n = 6). A right upper quadrant mass was palpable in 7 patients and gallstones were present in 5 patients. Diagnosis was established by intravenous cholangiogram and ultrasound. The operation was performed through a right subcostal laparotomy. The choledochal cyst diameter ranged from 4.5 to 7 cm. The cyst and the common duct were dissected from the hepatic artery and portal vein. The choledochus was sectioned above the duodenum and the distal end was closed by interrupted sutures. The common duct was divided below the hepatic confluence and the diameter enlarged by longitudinal section of the left hepatic duct. A 30-cm-long segment of isolated jejunum was passed through the transverse mesocolon to the right of the middle colic vessels and behind the duodenum and then interposed between the hepatic confluence and the second portion of the duodenum. Biliary-jejunal anastomosis was performed in 1 layer with interrupted absorbable stitches. No mortality or serious complications occurred during follow-up (1-4 years). No cholangitis, fever, or pain have developed. All patients were studied postoperatively by biochemical test, ultrasonography, Tc 99m DISIDA, and barium meal swallow. Good liver function and biliary excretion, and absence of duodeno-jejuno biliary reflux were demonstrated.

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“…They consider that anastomosis of the cyst wall to the duodenum (Gross, 1953;Ross and Carling, 1948) is liable to stasis and ascendmg cholangitis, and advocate excision of the cyst and direct anastomosis of the common hepatic or right and left hepatic ducts to the duodenum. Other methods of reconstruction after excision of the cyst include jejunal Row-en-Y anastomosis (Keeley, 1948), cholecysto-duodenostomy (Davis, 1948), and anastomosis of the retained upper pole of the cyst to the duodenum (McLaughlin, 1946). Gross states that excision of the cyst is entirely unnecessary and suggests direct anastomosis between cyst and duodenum with or without a relieving cholecystostomy.…”

Section: Discussionmentioning

confidence: 99%