title: Clinicopathological feature and surgical outcome of choledochal cyst in different age groups: the implication of surgical timing.
abstract: OBJECTIVE
  Surgical resection of choledochal cysts (CC) has become standard treatment. However, surgery is not universally recommended in early infancy and/or asymptomatic patients. In order to investigate the optimal timing of CC excision, we analyzed clinicopathological data and surgical results from different age groups.
  
  
  METHODS
  This retrospective review included 107 patients (77 females, 30 males) who underwent CC resection at the National Taiwan University Hospital between January 1988 and December 2005. Patient demographic, clinical, and surgical data were collected and analyzed.
  
  
  RESULTS
  The patients were divided into three groups according to age at the time of surgery: <1 year old (group I, n = 26), 1-16 years old (group II, n = 48), and >16 years old (group III, n = 33). About two thirds of the patients in group I had jaundice, while abdominal pain related to inflammation was the commonest symptom in groups II and III. Group I suffered significantly fewer surgical complications and less severe liver fibrosis than groups II or III.
  
  
  CONCLUSIONS
  CC surgery in infancy and in asymptomatic patients is safe and may prevent the complications of this condition. The results support a recommendation for early excision.
authors.affiliation: Department of Surgery, National Taiwan University Hospital, No 7, Chung-Shan South Rd, Taipei, Taiwan.
authors.forename: Ming-Shian
authors.initials: MS
authors.lastname: Tsai
authors.forename: Wen-Hsi
authors.initials: WH
authors.lastname: Lin
authors.forename: Wen-Ming
authors.initials: WM
authors.lastname: Hsu
authors.forename: Hong-Shiee
authors.initials: HS
authors.lastname: Lai
authors.forename: Po-Huang
authors.initials: PH
authors.lastname: Lee
authors.forename: Wei-Jao
authors.initials: WJ
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D015529:Choledochal Cyst / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome