title: Management strategy for congenital choledochal cyst with co-existing intrahepatic dilation and aberrant bile duct as well as other complicated biliary anomalies.
abstract: The purpose of this study was to investigate and discuss imaging methods and management strategies for congenital choledochal cyst with co-existing intrahepatic dilation and aberrant bile duct as well as other complicated biliary anomalies. In this study we reviewed and analyzed 72 patients with congenital choledochal cyst, ranging in age from 15 days to 12 years old and who were seen at our hospital during the past 12 years, from January 1993 to October 2005. The image manifestation and clinical significance of patients with co- existing intrahepatic biliary dilation and aberrant bile duct were carefully examined during operation via MRCP, cholangiography and choledochoscope. Twenty-two cases (30.1%) presented with intrahepatic bile duct dilation and 12 of these were of the cystic type. That is, the orifice of the dilated intrahepatic tract that converged into the common hepatic duct showed membrane or septum-like stenosis. In 10 cases the dilation tapered off from the porta hepatis to the initiating terminals of the intra-hepatic bile ducts and was not accompanied by stenosis. An aberrant bile duct was observed in 2 of the cases. In 3 cases, the right and left hepatic ducts converged at the choledochal cyst. In conclusion, the imaging methods for intrahepatic bile duct dilation possess important clinical significance. Further, for hepatojejunostomy with radical excision of a choledochal cyst, additional operative procedures for intrahepatic stenosis, possible bile duct malformation and pancreaticobiliary common duct calculi can potentially reduce postoperative complications.
authors.affiliation: Department of Pediatric Surgery, The Affiliated Hospital of Medical College, Qing Dao University, Qing Dao City, Qing Dao 266003, China. dong.qian@qdumh.qd.sd.cn
authors.forename: Qian
authors.initials: Q
authors.lastname: Dong
authors.forename: Buxian
authors.initials: B
authors.lastname: Jiang
authors.forename: Hong
authors.initials: H
authors.lastname: Zhang
authors.forename: Zhong
authors.initials: Z
authors.lastname: Jiang
authors.forename: Hongting
authors.initials: H
authors.lastname: Lu
authors.forename: Chuanmin
authors.initials: C
authors.lastname: Yang
authors.forename: Yu
authors.initials: Y
authors.lastname: Cheng
authors.forename: Xiwei
authors.initials: X
authors.lastname: Hao
mesh_terms: D001652:Bile Ducts / Q000002:abnormalities* / Q000473:pathology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D002758:Cholangiography; D015529:Choledochal Cyst / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008107:Liver Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography