Choledochal cyst is the rare disease with the dilatation of the biliary tree. This abnormality of biliary system is common in female and Oriental area. Advanced diagnostic procedures to visualize the biliary system such as ultrasonogram and
abdominal CT
scanning are demonstrating an increasing number of unsuspected choledochal cyst.
Authors reviewed 26 cases of choledochal cyst treated surgically at the department of general surgery, school of medicine, Hallym University during the periods of Jan 1983 to June 1992.
@ES The results were as follows:
@EN 1) The ratio of female to male was 3.3 : 1 which revealed predominance in female and age ranged from 2 months to 50 years old.
2) The main clinical symptoms and signs were, in order of frequency, RUQ abdominal pain (69.2%), mass(30.8%), nausea and vomiting(26.9%), jaundice, hepatosplenomegaly, and tenderness (15.3%, respectively).
3) Alkaline phosphatase was elevated in 15 cases(57.6%) and bilirubin in 7 cases(26.9%) and transaminase in 12 cases(46.2%).
4) Preoperative diagnostic studies were ultrasonography(76.9%), ERCP(30.7%), UGIS(26.9%), and transaminase in 12 cases(46.2%).
5) Preoperative diagnosis was choledochal cyst in 24 cases(92.3%) and CBD stone and peritonitis in 1 cases(3.8%) respectively.
6) The associated disease were CBD stone(4 cases), acute pancreatitis(4 cases), intrahepatic duct stone(2 cases) and diabetes(2 cases).
7) The most common type according to the Todani's classificantion was Type I(73.1%), and Type IV-a (26.9%).
8) The most commonly used surgical procedure was cyst excision and Roux-en-Y hepaticojejunostomy 24 cases(92.3%), and in 2 cases, T tube drainage only and cystojejunostomy were performed.
9) The postoperative complications were bile leakage in 3 cases(11.5%), wound infection in 2 cases(7.6%), pleural effusion in 1 cases(3.8%). The mortality rate was 3.8%.
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