Abstract
OBJECTIVE:To identify the best mode for diagnosing and treating the patients with choledochal cysts.METHODS:A retrospective study was performed with medical records of patients diagnosed with choledochal cysts from January 1994 to December 2017. In all cases, the diagnosis was based on ultrasound examination. All the patients underwent cyst resection and were divided in two groups: bile enteric anastomosis in the high portion of the common hepatic duct or in the dilated lower portion.RESULTS:Eighty-one cases were studied. The age of presentation was 4 y 2 mo ± 4 y 1 mo, and the age for the surgical treatment was 5 y 5 mo ± 4 y 6 mo. In 61 cases, US was the only image examination performed. There were 67 cases of Todani type I (82.7%), 13 cases of type IV (16.0%) and one case of type III (1.2%). Nine patients (29.0%) in the first period and 2 patients (4.0%) in the second period presented with postoperative complications (p=0.016).CONCLUSION:In patients with choledochal cysts, US is the only necessary diagnostic imaging. Performing the bile enteric anastomosis in the lower portion of the common hepatic duct is safer and has a lower risk of complications.
Highlights
Choledochal cyst, or congenital bile duct dilatation, is a rare pathology, with a higher incidence in the Far East [1,2]
Some cases were referred to our institution with prior imaging exams, such as US, magnetic resonance cholangiopancreatography (MRCP) or computed tomography (CT)
With regards to a large series of cases of choledochal cysts in children treated in a single reference center of pediatric liver diseases and liver transplantation, some points must be discussed
Summary
Choledochal cyst, or congenital bile duct dilatation, is a rare pathology, with a higher incidence in the Far East [1,2]. It was first described in 1723 by Vater and Ezler and has a predisposition to develop into cholangiocarcinoma in adult life. The prevalence of APBDJ association with choledochal cysts is 97% [3,4,5,6]. Other types of imaging may assist in surgical planning, but they do not change the final management of the disease
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
