Choledochal cysts are congenital anomalies of the bile ducts that include. Pdf results of the surgical management of 17 choledochal cysts in adults at the department of surgery, siriraj hospital, mahidol university, are. Choledochal cysts are rare disease and of unknown etiology. Scribd is the worlds largest social reading and publishing site. They are typically a surgical problem of infancy and childhood, but in nearly 20% of the patients the diagnosis is delayed until adulthood. The treatment of choice of type i bile duct cysts in adults is total cystectomy and rouxeny hepaticojejunostomy. Diagnosis of choledochal cyst is concluded upon disproportionate expansion of extrahepatic bile duct. Choledochal cyst in a female adult asymptomatic patient peertechz. The typical patient with choledochal cyst disease has been the female infant with the triad of jaundice, an abdominal mass, and pain. Treatment of choledochal cyst page 3 of 4 9 r e e pr. Choledochal cyst presentation and treatment in an adult. Left untreated, this frequently lead to recurrent cholangitis inflammation and infection in the bile ducts or pancreatitis inflammation of the pancreas. Choledochal cysts in adults article pdf available in annals of the royal college of surgeons of england 796.
Bile duct surgery with total cyst removal is the definitive treatment for choledochal cysts. Cysts located on the intrahepatic bile ducts caroli disease are treated when complications occur such as bile duct strictures. Pdf choledochal cysts are a congenital anomaly, and they show dilatation of the intra or extrahepatic biliary tree. Choledochal cyst compiled free download as powerpoint presentation. A new classification system is proposed according to location and extension of the bile duct dilatation and clinical features. In the case of subtype v, the extent of liver resection depends on. There were 10 todani type i, and four type iv cysts.
Authors evaluate robotic surgery for pediatric choledochal cyst versus open surgery in a small retrospective study, and their findings support the validity and feasibility of robotic surgical. Diagnosis and management of choledochal cysts ncbi. The presentation and therapeutic strategies for choledochal cysts in adult may differ from that of childhood. Presentation and outcomes of choledochal cysts in children. Total cyst excision of the extrahepatic duct and hepaticojejunostomy is recommended.
Controversy about the surgical treatment of choledochal cysts. Get a printable copy pdf file of the complete article 2. University gastroenterohepatology clinic, medical faculty. The distal classification and management of choledochal cyst. Type iv a choledochal cyst with cystic duct cyst hpb oxford 2010. The clinical features and management of 14 adults with choledochal cysts who presented to our hospital are discussed. The authors compared the presentation, treatment, and longterm outcome of children and adults with choledochal cysts. Surgical treatment depends on the anatomic findings and extent of biliary involvement according to the widely used todani classification. Importance choledochal cysts ccs are rare, with risk of infection and cancer objective to characterize the natural history, management, and longterm implications of cc disease design, setting, and participants a total of 394 patients who underwent resection of a cc between january 1, 1972, and april 11, 2014, were identified from an international multiinstitutional database. The classic triad of intermittent abdominal pain, jaundice and a palpable right upper quadrant abdominal mass occurs in fewer than 20% of patients, although almost two thirds of patients present with two of the three symptoms. J gen surg removal of the intrapancreatic portion of the cyst, as residues may lead to secondary carcinogenesis of the bile duct and morbidity. Cyst excision is the definitive treatment of choice for choledochal cyst.
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