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Endoscopic aspects of choledochoceles

H G Schmidt1, J Bauer, V Wiessner

  • 1Medizinische Klinik, Klinikum Nürnberg, Germany.

Hepato-Gastroenterology
|January 1, 1996
PubMed
Summary

Choledochoceles are rare, with a 0.1% incidence found in this study. Smaller choledochoceles are often asymptomatic, while larger ones present with symptoms, often treatable with endoscopic papillotomy.

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Area of Science:

  • Gastroenterology
  • Hepatobiliary Surgery

Background:

  • Choledochoceles are rare cystic formations of the distal common bile duct.
  • Limited data exists on the incidence and clinical presentation of choledochoceles.

Purpose of the Study:

  • To determine the incidence of choledochoceles.
  • To analyze the clinical characteristics and outcomes of choledochoceles.

Main Methods:

  • Retrospective analysis of 9,850 patients who underwent Endoscopic Retrograde Cholangiopancreatography (ERCP).
  • Review of medical histories for patients diagnosed with choledochoceles.

Main Results:

  • A choledochocele incidence of 0.1% (10 out of 9,850 patients) was identified.
  • Of the 10 choledochoceles, 3 were symptomatic, 3 questionably symptomatic, and 4 asymptomatic.
  • Endoscopic papillotomy was performed on 6 symptomatic or questionably symptomatic patients, with 4 achieving symptom relief.

Conclusions:

  • Choledochocele size correlates with symptomatology: smaller cysts are typically asymptomatic, larger ones symptomatic.
  • Endoscopic Retrograde Cholangiopancreatography (ERCP) is the diagnostic method of choice.
  • Endoscopic treatment, specifically papillotomy, can be effective for symptomatic choledochoceles.

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