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Recent experience with choledochal cyst.

J A O'Neill, J M Templeton, L Schnaufer

    Annals of Surgery
    |May 1, 1987
    PubMed
    Summary
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    Choledochal cyst treatment in children shows cyst excision is the preferred method. This surgical approach, whether primary or secondary, leads to better outcomes compared to other procedures for choledochal cysts.

    Area of Science:

    • Pediatric Surgery
    • Gastroenterology
    • Hepatobiliary Surgery

    Background:

    • Choledochal cysts are congenital dilations of the bile ducts.
    • Presentation varies, with infantile cases mimicking biliary atresia and later-onset cases presenting with pain, mass, or jaundice.

    Purpose of the Study:

    • To evaluate the long-term outcomes of different surgical treatments for choledochal cysts in pediatric patients.

    Main Methods:

    • Retrospective review of 17 patients (newborn to 17 years) treated for choledochal cysts over 11 years.
    • Analysis of surgical procedures including cystoduodenostomy, Roux-Y cystojejunostomy, and cyst excision with hepaticojejunostomy.

    Main Results:

    • Cyst excision, primary or secondary, with Roux-Y hepaticojejunostomy yielded excellent results in all patients (n=9).

    Related Experiment Videos

  • Cystoduodenostomy (n=2) and Roux-Y cystojejunostomy (n=6) required revisions in some cases.
  • Infantile group (n=17, mean age 3 months) presented with obstructive jaundice; late-onset group (n=17, mean age 9 years) presented with pain, mass, and jaundice.

    • Conclusions:

    • Cyst excision is the recommended primary or secondary treatment for choledochal cysts.
    • Specific approaches like hepatic lobectomy for Caroli's disease and cyst unroofing for choledochocele are indicated based on anatomy.