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Variation in management based on type of choledochal cyst
R R Lopez1, C W Pinson, J R Campbell
1Department of Surgery, Oregon Health Sciences University, Portland.
American Journal of Surgery
|May 1, 1991
Summary
Surgical management of choledochal cysts, including cyst excision and choledochoenterostomy for types I and II, is effective. Endoscopic procedures offer alternatives for specific choledochal cyst types.
Area of Science:
- Gastroenterology
- Hepatobiliary Surgery
- Pediatric Surgery
Background:
- Choledochal cysts are congenital bile duct dilatations.
- Management strategies have evolved over time.
- Early diagnosis and treatment are crucial for favorable outcomes.
Purpose of the Study:
- To review the management and outcomes of choledochal cyst patients.
- To evaluate the efficacy of different surgical and endoscopic interventions.
- To establish optimal treatment guidelines based on cyst type.
Main Methods:
- Retrospective review of 23 patients treated between 1969 and 1990.
- Diagnosis confirmed by ultrasound and/or cholangiography.
- Surgical interventions included cyst excision, choledochoenterostomy, and endoscopic procedures.
Main Results:
- No operative deaths; two postoperative complications (cholangitis, prolonged ileus).
- Complete resolution of pain and jaundice in all patients.
- Specific treatments: cyst excision for types I/II, endoscopic procedures for type III, extrahepatic excision for type IV.
Conclusions:
- Complete cyst excision with choledochoenterostomy is the gold standard for types I and II choledochal cysts.
- Extrahepatic cyst excision and choledochojejunostomy are suitable for type IV cysts.
- Endoscopic incision and drainage is appropriate for selected type III choledochal cysts.