KMID : 0816120140170030170
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Korean Journal of Pediatric Gastroenterolology and Nutrition 2014 Volume.17 No. 3 p.170 ~ p.177
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Relationship between Anomalous Pancreaticobiliary Ductal Union and Pathologic Inflammation of Bile Duct in Choledochal Cyst
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Park So-Won
Koh Hong Oh Jung-Tak Han Seok-Joo Kim Seung
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Abstract
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Purpose: Choledochal cyst is a cystic dilatation of common bile duct. Although the etiology is presently uncertain, anomalous pancreaticobiliary ductal union (APBDU) is thought to be a major etiology of choledochal cyst. In this study, we analyzed the clinical and anatomical characteristics and pathologies of patients diagnosed with chol-edochal cyst in a single institute for 25 years.
Methods: A total of 113 patients, diagnosed with choledochal cyst and who received an operation in Severance Children¡¯s Hospital from January 1988 to May 2013, were included. Medical records were reviewed, including clinical and demographic data, surgical procedures. Abdominal ultrasonography, magnetic resonance cholangiopancreatog-raphy, and intraoperative cholangiography were used as diagnostic tools for evaluation and classification of chol-edochal cyst and the presence of anomalous pancreaticobiliary ductal union. Todani¡¯s classification, and relationship between APBDU and surgical pathology.
Results: Among 113 patients, 77 patients (68.1%) presented symptoms such as hepatitis, pancreatitis and/or cholecystitis. Eighty three patients (73.5%) had APBDU, and 94 patients (83.2%) showed inflammatory pathologic changes. APBDU, pathologic inflammation, and serological abnormalities such as hepatitis or pancreatitis showed a statistically significant correlation to one another.
Conclusion: APBDU is thought to be one of the etiologic factors of choledochal cyst. It is related to the inflammatory changes in bile duct that can lead to the cystic dilatation.
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KEYWORD
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Pancreatic ducts/abnormalities, Child, Choleodchal cyst
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