Surgical management of choledochal cysts

Scudamore, Charles H.; Hemming, Alan W.; Teare, Julian; Fache, J S; Erb, Sigfried R.; Watkinson, Anthony

doi:10.1016/0002-9610(94)90243-7

Cited by 60 publications

(36 citation statements)

References 17 publications

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“…But intraoperative cholangiography is not sensitive enough to detect the presence of an abnomal pancreaticobiliary duct junction. Radiographic visualization of both the biliary tree and pancreatic duct prior to surgery is helpful for surgical manipulation and complete excision of the cyst [5][6][7][8] . Other pathologic features of choledochal cysts include acute and chronic mucosal inflammation, mucosal dysplasia, and absence of smooth or elastic fibers.…”

Section: Discussionmentioning

confidence: 99%

“…Although the occurrence of intrahepatic cholangiocarcinoma after the excision of a type I cyst has been reported [18,19] , but cyst excision is the primary choice of treatment for type I cysts. Type III cysts require adequate drainage and generally can be managed by endoscopic sphincterotomy and cannot be undertaken, operative sphincteroplasty with transduodenal cyst excision might be attempted [5] . Sphincteroplasty either endoscopically or surgically has been found to be satisfactory [20] .…”

Section: Discussionmentioning

confidence: 99%

“…Treatment for type IV cysts is still controversial. Either excision of the extrahepatic cyst alone [5] or total cyst excision including hepatectomy [21] has been recommended. Concerning type V cysts, some authors recommended hepatic resection for unilobar Caroli's disease [1] .…”

Section: Discussionmentioning

confidence: 99%

“…Concerning type V cysts, some authors recommended hepatic resection for unilobar Caroli's disease [1] . Complete excision of the extrahepatic bile duct from the hepatic hilum to the pancreaticobiliary duct junction has become the choice of treatment for types I and IV cysts [3][4][5]9,11,19,[21][22][23] . However, it should be mentioned that since complete excision seems to be difficult in some patients, pancreaticoduodenectomy or hepatic resection should then be considered.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Choledochal cysts in pregnancy: Case management and literature review

Zheng²,

Wang³

et al. 2004

WJG

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show abstract

“…1) [1,5,6,[14][15][16][17][18]. The management of choledochal cysts are mainly surgical [1,2,5,14,[17][18][19][20][21][22][23]. However in selected cases, a choledochocele may be treated by endoscopic sphincterotomy [14].…”

Section: Introductionmentioning

confidence: 99%