Is excision of a choledochal cyst in the neonatal period necessary?
OBJECTIVE
Although the incidence of choledochal cyst (CC) diagnosed in the prenatal or neonatal period is increasing, excision of CC in early infancy is not universally recommended. To validate the rationale of excision of CC in the neonatal period, operative complications and the histologic grade of liver fibrosis at the time of excision of CC were compared in three age groups.


METHODS
198 patients who underwent excision of CC, were divided into three age groups, i.e., within 30 days old (group 1, n = 11), 1 to 12 month-old (group 2, n = 40) and over 12 month-old (group 2, n = 147). Retrospective review of their medical records was performed.


RESULTS
The overall operative complications were 12 (7 cholangitis, 4 bleeding, 1 ileus). No complication occurred in the group 1. The grade of liver fibrosis had statistically significant positive correlation among groups.


CONCLUSIONS
Excision of CC in the neonatal period is a safe procedure. The grade of liver fibrosis increased with age. These results support the rationale of early excision of CC.
Lee
Seong-Cheol
SC
Department of Pediatric Surgery, Seoul National University Children's Hospital, Chongno-ku, Seoul, 110-744, Korea.
Kim
Hyun-Young
HY
Jung
Sung-Eun
SE
Park
Kwi-Won
KW
Kim
Woo-Ki
WK
D000367:Age Factors; D001662:Biliary Tract Surgical Procedures / Q000009:adverse effects*; D002675:Child, Preschool; D015529:Choledochal Cyst / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008103:Liver Cirrhosis / Q000209:etiology / Q000517:prevention & control; D008297:Male; D011183:Postoperative Complications