This is an analysis of 24 patients of choledochal cysts which had been operated at the department of the surgery of St. Benedict Hospital for 19 years from january 1975 to january 1994. Clinical analysis was carried out on these caes with a
review
of
literature.
@ES The results were as follows:
@EN 1) the male to female ratio was 1:3, thus showing a predoinance of females.
2) Young age group who were less than 30 years old showed 12(50%) out of 24 cases.
3) Frequency of each symptom in classic triad was in order of abdominal pain(79.2%) jaundice (54.2%) and palpable mass(33.3%), respectively. Those who have had all symptoms triad were 5 patients(20.8%).
4) The concomitant bile duct stone was noted in 10 cases(41.7%) and one patient who ad a long history of symptoms was found to have carcinoma of gall bladder.
5) According to Todani's classification, the patients with choledochal cysts were classified as:16 cases(66.7%) of type I, 4 cases(16.7%) of type Ⅱ, 2 cases(8.3%) of typeⅢ, and 2 cases(8.3%) of typeⅣa.
6) the surgical procedures were as: excision of cyst and Roux-en-Y hepatico-jejunostomy in 10 cases(41.7%), choledochocystoduodenostomy in 8 cases(33.3%), partial resection of cyst and T-tube cholecdochostomy in 3 cases(12.5%), Roux-en-Y
choledochocystojejunostomy in 2 cases(8.3%), and external drainage in 1 case(4.2%).
7) The postoperative complications were noted in 6 cases(25.0%): wound infection was found in 2 cases, recurrent ascending cholangitis in 2 cases, partial intestinal obstruction in 1 case, and sepsis in 1 case.
The trend of surgical procedures has been changing from simple drainage procedure, such as choledochoduodenostomy or Roux-en-Y cystojejunostomy to cholecystectomy, excision of choledochal cysts and Roux-en-Y hepatiecojejunostomy. At present, the
choice
of operative procedure is cholecystectomy, complete excision of choledochal cysts and reconstruction of the biliary duct with Roux-en-Y hepaticojenunostomy in our department.
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