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KMID : 0191120040190060842
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Journal of Korean Medical Science
2004 Volume.19 No. 6 p.842 ~ p.847
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Experience of Congenital Choledochal Cyst in Adults:Treatment, Surgical Procedures and Clinical Outcome in the Second Affiliated Hospital of Harbin Medical University
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Zheng LX
Jia HB/Wu DQ/Shang H/Zhong XY/Wang QS/Zhou WX/Sun ZH
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Abstract
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This study was undertaken to analyze and evaluate the diagnosis and principal treatment methods for congenital choledochal cyst, focusing on various surgical procedures and clinical outcome. A comprehensive, retrospective study was con-ducted on 72 adult patients who presented with choledochal cyst from 1985 to 2002. Surgical procedures were cyst excision with hepaticojejunostomy in 25 cases for type I or type IV-B, extrahepatic cyst excision with hepaticojejunostomy in 8 cases for type IV-A, extrahepatic cyst excision with modified hepaticojejunostomy in 2 cases for type IV-B, non-cyst excision with or without hepaticojejunostomy in 27 cases for types I, II, IV-A, IV-B. The early postoperative morbidity and mortality rate were 16.1% (9/62) and 6.5% (4/62) respectively, and the complication rate related to surgical procedure was 30.6% (19/62). The incidence of cholangiocarci-noma with non-cyst excision or non-operated congenital choledochal cyst was 10.8% (4/37). One patient died of primary hepatocellular carcinoma after cyst exci-sion with hepatojejunostomy. In conclusion, our results showed that complete exci-sion of choledochal cyst for types I, II, and IV-B and complete excision of extra-hepatic choledochal cyst from the hepatic hilum in type IV-A with hepaticojejunos-tomy or modified hepaticojejunostomy are the treatment of choice for choledochal cyst in adult patients.
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