Choledochal cyst may be defined as a rare congenital dilatation of the common bile duct that is often associated with a congenital or acquired dilatation of the intrahepatic ducts.
We reviewed 21 cases (4 male, 17 female) of choledochal cyst treated surgically in a 7 year period from January, 1988 to December, 1994 at Kangdong Sacred Heart Hospital.
Their Ages ranged from 48 days to 67 years with the majority(7 patients) in the pediatric age group(<14 years)
The clinical symptoms were characterized by abdominal pain(71.4%), jaundice(57.1%) and a palpable mass(38.0%), but this classic triad was present in only 7 cases(33.3%).
Preoperative diagnostic studies were ultrasonography(85.7%), ERCP(61.9%), abdominal CT and (19%), hepatobiliary scan(14.2%).
Serum levels of alkaline phosphatases and Transaminases were elevated in 71.4% and 52.3% of the patients, respectively and serum bilirubin was elevated in 47.6% of patients.
According to the classification of Todani, sixteen patients(76.1%) were of type I and five patints(23.8%) were of type IV-A.
Operative procedures were excision of the cyst and biliary reconstruction with Roux-en-Y hepatico-jejunostomy(20 cases) and cystojejunostomy(1 case).
Associated diseases were GB and CBD stones(6 cases) acute pancreatitis (3 cases), intrahepatic duct stone(2 cases) and one case of carcinoma arising from the cyst wall.
Post operative ascending cholangitis occured in three patients and wound complications were noted in two patients.
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