title: Experience of congenital choledochal cyst in adults:treatment, surgical procedures and clinical outcome in the Second Affiliated Hospital of Harbin Medical University.
abstract: This study was undertaken to analyze and evaluate the diagnosis and principal treatment methods for congenital choledochal cyst, focusing on various surgical procedures and clinical outcome. A comprehensive, retrospective study was conducted on 72 adult patients who presented with choledochal cyst from 1985 to 2002. Surgical procedures were cyst excision with hepaticojejunostomy in 25 cases for type I or type IV-B, extrahepatic cyst excision with hepaticojejunostomy in 8 cases for type IV-A, extrahepatic cyst excision with modified hepaticojejunostomy in 2 cases for type IV-B, non-cyst excision with or without hepaticojejunostomy in 27 cases for types I, II, IV-A, IV-B. The early postoperative morbidity and mortality rate were 16.1% (9/62) and 6.5% (4/62) respectively, and the complication rate related to surgical procedure was 30.6% (19/62). The incidence of cholangiocarcinoma with non-cyst excision or non-operated congenital choledochal cyst was 10.8% (4/37). One patient died of primary hepatocellular carcinoma after cyst excision with hepatojejunostomy. In conclusion, our results showed that complete excision of choledochal cyst for types I, II, and IV-B and complete excision of extrahepatic choledochal cyst from the hepatic hilum in type IV-A with hepaticojejunostomy or modified hepaticojejunostomy are the treatment of choice for choledochal cyst in adult patients.
authors.affiliation: Department of Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin, China. zhenglxhrbmu@hotmail.com
authors.forename: Long-Xian
authors.initials: LX
authors.lastname: Zheng
authors.forename: Hong-Bo
authors.initials: HB
authors.lastname: Jia
authors.forename: De-Quan
authors.initials: DQ
authors.lastname: Wu
authors.forename: Hong
authors.initials: H
authors.lastname: Shang
authors.forename: Xiang-Yu
authors.initials: XY
authors.lastname: Zhong
authors.forename: Qiu-Shi
authors.initials: QS
authors.lastname: Wang
authors.forename: Wen-Xue
authors.initials: WX
authors.lastname: Zhou
authors.forename: Zhen-Hua
authors.initials: ZH
authors.lastname: Sun
mesh_terms: D000046:Academic Medical Centers / Q000639:trends; D000293:Adolescent; D000328:Adult; D015529:Choledochal Cyst / Q000453:epidemiology* / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000379:methods* / Q000706:statistics & numerical data*; D006801:Humans; D007582:Jejunostomy / Q000379:methods* / Q000706:statistics & numerical data*; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D016896:Treatment Outcome