Recent advances in choledochal cysts

Abstract

Choledochal cysts are a congenital anomaly, and they show dilatation of the intra- or extrahepatic biliary tree. These cysts are uncommon in Western countries, but are not rare in Asian countries. Choledochal cysts are classified into five groups based on location or shape of the cysts. Types I and IV-A cysts are the most common types, which are associated with anomalous pancreaticobiliary junction (APBJ), but other cysts are not associated with APBJ. Types I and IV-A cysts appear to belong to a different category from other cysts embryologically. Type I and IV-A cysts accompany anomalies of the pancreas. Type I and IV-A cysts might occur when left ventral anlage persists, and with disturbed recanalization of the common bile duct. Endoscopic retrograde cholangiopancreatography is the gold standard for detecting APBJ, but it is an invasive procedure. Magnetic resonance cholangiopancreatography (MRCP) is a non-invasive imaging tool for detecting pancreatic and biliary trees. MRCP is the first-choice modality for diagnosing choledochal cysts and APBJ in pediatric patients. Cystoenterostomy is been performed because of high complication and mortality rates. Complete excision of the cysts with Roux-en-Y hepatojejunostomy is a standard procedure for choledochal cysts to prevent postoperative complications, including development of cancer. In this study, we review classification, pathogenesis, diagnosis, and treatment of types I and IV-A choledochal cysts

Comparison of MRCP with Intraoperative Cholangiography in Paediatric Choledochal Cyst and Biliary Atresia

“…Abnormal pancreaticobiliay duct union could be delineated by MRCP in 12 cases (40%) out of 30 choledochal cyst patients. Our findings were similar to that reported by authors like Huang S J et al [3], Anupindi S A et al [17] and Kim et al [16].…”

“…Ultrasonography is considered as the first screening tool for all the patients of neonatal cholestasis [3]. Technique development offers a variety of algorithms for surveillance of biliary and pancreatic structures including intra-operative cholangiogram (IOC), MRCP and CT Cholangiopancreaticography [4].…”

Treatment and outcomes of adults with remnant intrapancreatic choledochal cysts

“…12 Complete excision of the cystic areas with Roux-en-Y hepatojejunostomy is the best treatment for most patients. 13 Surgeons, however, may not to perform complete excision in certain circumstances, for example, when the cystic lesion extends deeply into the pancreas. 14 The operation is very difficult.…”

Bile Duct Cysts: Modern Aspects of Surgical Treatment and Clinical Observation of a Rare Case

“…У взрослых также возмож-но одновременное течение патологических процессов в гепатобилиарной и поджелудочной области, что может осложнить оценку и диагностику заболеваний [14][15][16]. У 80% неоперированных взрослых возникают осложне-ния в виде холедохо-и гепатиколитиаза, калькулезного холецистита, панкреатита, внутрипеченочных абсцессов, цирроза печени, портальной гипертензии и даже холан-гиокарциномы [17,18].…”