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Choledochal cyst in the adult
S C Stain1, C R Guthrie, A E Yellin
1Department of Surgery, University of Southern California, School of Medicine, Los Angeles, USA.
Annals of Surgery
|August 1, 1995
Summary
Surgical treatment of adult choledochal cysts shows a high cancer incidence (26%) and frequent complications with bypass procedures. Early cyst excision is recommended for better outcomes and to mitigate cancer risk.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Hepatobiliary Surgery
Background:
- Choledochal cysts are rarely diagnosed in adults.
- Surgical excision is preferred over bypass for effective biliary drainage and cancer risk reduction.
Purpose of the Study:
- To examine the natural history of surgically treated adult choledochal cysts.
- To determine the frequency of anastomotic complications and cancer incidence in adults with choledochal cysts.
Main Methods:
- Retrospective study of 27 adult patients with choledochal cysts.
- Analysis of surgical outcomes, including anastomotic complications and cancer development.
Main Results:
- Cyst excision had a low stricture rate (1/15).
- Cyst enterostomy resulted in a high rate of anastomotic revision (8/11).
- Cancer was diagnosed in 26% of patients, with a poor prognosis.
Conclusions:
- Adult choledochal cysts have a high cancer incidence (26%) and high stricture rates with cyst enterostomy (73%).
- Prompt surgical excision is crucial, even for asymptomatic patients, due to the poor prognosis of associated cancers.
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