Cystic dilation of extrahepatic bile ducts in adulthood: diagnosis, surgical treatment and long-term results.
To evaluate the long-term results of surgery for choledohal cyst in adulthood, a series of 13 patients over the age of 16 operated on for choledochal cyst during a period of six years and followed-up for a minimum of 3 years was analyzed. Patients with type I and IVa cysts underwent extrahepatic cyst resection and Roux-en-Y hepatico-jejunostomy. Choledochoceles (type III) were managed endoscopically. No operative mortality or morbidity occurred. Type I and III cysts showed almost ideal follow-up with no sign of stricture on HIDA scan. One type IVa cyst patients developed recurrent cholangitis due to anastomotic stricture, managed percutaneously. Whenever possible, complete cyst resection and Roux-en-Y reconstruction is the treatment of choice for all extrahepatic biliary cysts. Intra- and extrahepatic dilatations are adequately treated by extrahepatic resection and careful endoscopic or radiologic surveillance. Small choledochoceles can be safely managed by endoscopic sphincterotomy.
Belli
G
G
Department of General Surgery & Organ Transplantation, University of Naples Federico II, School of Medicine, Italy.
Rotondano
G
G
D'Agostino
A
A
Iannelli
A
A
Marano
I
I
Santangelo
M L
ML
D000293:Adolescent; D000328:Adult; D000713:Anastomosis, Roux-en-Y; D017734:Bile Ducts, Extrahepatic / Q000473:pathology; D002761:Cholangitis / Q000209:etiology; D015529:Choledochal Cyst / Q000145:classification / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000209:etiology; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome