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KMID : 0390119940340020161
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Journal of Pusan Medical College
1994 Volume.34 No. 2 p.161 ~ p.168
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Clinical Analysis of Choledochal Cyst
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심문섭
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Abstract
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Choledochal cyst or cystic dilatation of the other portion of the biliary tree, occur uncommonly.
Vater first reported a cases of this disease in 1723, more than 1500 cases have been reported in the world's literature.
This abnormality of bile duct is more common in orient, especially in Japan than other countries.
Recently, the frequently of reported cases has increased due to improvement of diagnostic methods such as ultrasonogram and abdominal CT scanning.
Author reviewed 26 cases of choledochal cyst treated surgically at the Department of General Surgery. College of Medicine, Pusan National University, during the period of January 1980 to December 1992.
@ES The results were as follows:
@EN 1) The ratio of female to male was 2.7 : 1 which revealed predominance in female and age ranged from 21 months to 72 years old. The ratio of adult to chiidren was 2.8 : 1 at the time of treatment.
2) The main clinical symptoms and signs were abdominal pain 21 cases (80.9%), jaundice 14 cases (53.8%), abdominal tenderness 14 cases (53.8%) in order of frequency.
3) Alkaline phosphatase was elevated at 22 cases (84.6%) and hyperbilirubinemia and increased transaminase was observed in 46.2% of the patient respectively.
4) Preoperative diagnostic study was performed using ultrasonography (76.9%) abdominal CT (53.8%), hepatobiliary scan (42.3%) in order of frequently and the most commonly used diagnostic approach was abdominal sonogram.
5) Preoperative diagnosis was choledochal cyst in 22 cases (84.6%), liver abscess with acute cholangitis in 2 cases (7.7%) and pancreatic cyst with cholelithiasis in 2 cases (7.7%).
6) The most common associated disease was acute cholangitis 5 cases (19.2%).
7) According to the Todani's classification, the most common type was type I (69.2%) and type IV-A (15.4%), type II (7.7%), type III(7.7%) in order of frequency.
8) The most commonly used surgical procedure was excision and Roux-en-y hepatiojejunostomy in 19 cases (73.2%) and non excision(bypass only) procedure were performed in 5 cases (18.2%).
9) The postoperaitve complications were wound infection in 5 cases. bile leakage in 4 cases, postoperaitve pancreatitis in 3 cases and pneumonia in 2 cases.
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