title: Secondary excision of choledochal cysts after previous cyst-enterostomies.
abstract: OBJECTIVE
  Patients with a choledochal cyst previously treated by internal drainage should undergo secondary cyst excision. The results of such secondary excisions have not yet been reported.
  
  
  METHODS
  Over a 27-year period, 121 patients underwent excision of a choledochal cyst at our hospitals. Of these, 14 patients underwent secondary cyst excision following internal drainage. These patients were compared retrospectively with the remaining 107 patients who underwent primary cyst excision.
  
  
  RESULTS
  Blood loss and operative time were greater, and early and late post-operative complications were significantly more frequent in the secondary excision group. Wound infection (early complication), pancreatic stones (late complication), and hepatolithiasis (late complication) were significantly more common in the secondary excision group. Histologically, inflammation and biliary glands were more frequently seen in the resected bile ducts in the secondary excision group.
  
  
  CONCLUSIONS
  The long-term results of secondary excision of choledochal cysts are worse than after primary excision. The frequent late complications may be related to the development of biliary glands as a consequence of cyst-enterostomy.
authors.affiliation: Department of Pediatric Surgery, Nagoya University School of Medicine, Japan. kkaneko@tsuru.med.nagoya-u.ac.jp
authors.forename: K
authors.initials: K
authors.lastname: Kaneko
authors.forename: H
authors.initials: H
authors.lastname: Ando
authors.forename: Y
authors.initials: Y
authors.lastname: Watanabe
authors.forename: T
authors.initials: T
authors.lastname: Seo
authors.forename: T
authors.initials: T
authors.lastname: Harada
authors.forename: F
authors.initials: F
authors.lastname: Ito
authors.forename: N
authors.initials: N
authors.lastname: Niimi
authors.forename: M
authors.initials: M
authors.lastname: Nagaya
authors.forename: T
authors.initials: T
authors.lastname: Umeda
authors.forename: T
authors.initials: T
authors.lastname: Sugito
mesh_terms: D000293:Adolescent; D000328:Adult; D000713:Anastomosis, Roux-en-Y; D002648:Child; D002675:Child, Preschool; D015529:Choledochal Cyst / Q000473:pathology / Q000601:surgery*; D003135:Common Bile Duct / Q000473:pathology / Q000601:surgery; D004322:Drainage; D004766:Enterostomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007582:Jejunostomy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies