Procedures for congenital choledochal cysts and curative effect analysis in adults.
OBJECTIVE
To evaluate the procedures and timing of operation as well as long-term postoperative effect of congenital choledochal cysts (CCC) in adults.


METHODS
The procedures and timing of operation, effective rate, re-operation rate and incidence of carcinoma after operation for 70 adult patients with CCC from January 1980 to June 1999 were analyzed retrospectively.


RESULTS
The re-operation rate of external drainage was 86% (6/7). The effective rate of internal drainage was significantly lower than that of cyst resection (3/10 vs 45/49, chi2=20.94, P<0.001). The re-operation rate and incidence of carcinoma of internal drainage were higher than those of cyst resection (5/10 vs 3/49, chi2=13.64, P<0.001 and 3/10 vs 3/49, chi2=5.18, P<0.025). The reoperation rate of emergency surgery was higher than that of selective operation (8/10 vs 6/56, chi2=24.37, P<0.001).


CONCLUSIONS
External drainage should be the first-aid measure and the therapy of choice on emergency basis. Internal drainage should never be attempted. Cyst resection with Roux-en-Y hepaticojejunostomy is recommended as the treatment of choice in selective operation.
Tao
Kai-Shan
KS
Department of Hepatobiliary Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China. taokaishan@sina.com
Lu
Yong-Gang
YG
Wang
Ting
T
Dou
Ke-Feng
KF
D000230:Adenocarcinoma / Q000453:epidemiology / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000453:epidemiology / Q000209:etiology; D002277:Carcinoma / Q000453:epidemiology / Q000209:etiology; D015529:Choledochal Cyst / Q000150:complications / Q000601:surgery*; D004322:Drainage / Q000379:methods; D004385:Duodenostomy; D005260:Female; D006801:Humans; D015994:Incidence; D007582:Jejunostomy; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D016896:Treatment Outcome