Congenital cystic dilatation of the common bile duct: Follow-up in three cases and discussion of pertinent features

Abstract

Evaluation was made of the present condition of a girl, a boy and a woman subjected to choledochocystoduodenostomy eleven, eight and one and a half years previously. At the time of operation their ages were five and one-half, six and one-half and thirty-one years, respectively. Each patient had complained of episodes of pain in the upper part of the abdomen associated with nausea and vomiting. The boy also had had subclinical jaundice during his attacks of pain. None of the patients had a palpable abdominal mass on physical examination. During the eleven years since her operation, the girl has had no symptoms except for three brief episodes of subcostal discomfort which occurred in January, 1963 and may have been due to cholangitis. The boy, in the eight years following his operation, has also been well except for three bouts of abdominal pain, fever and elevated leukocyte count which occurred late in 1962. These may have been due to cholangitis from partial obstruction of the anastomotic opening since each bout followed ingestion of nut meats. On eliminating nut meats from his diet, he has had no further trouble. The woman has remained asymptomatic. Proximity of the common bile duct to the duodenum makes choledochocystoduodenostomy a simpler and safer operation than others that have been advocated for treatment of congenital cystic dilatation of the common bile duct. Unless it is diseased, the gallbladder is best not removed.