title: Congenital stenosis of the hepatic duct at the porta hepatis in children with choledochal cyst.
abstract: BACKGROUND
  The intrahepatic gallstone is known as one of the complications of choledochal cyst. Stenosis of the hepatic duct may contribute to the formation of the stone. This report describes concurrent congenital stenosis of the hepatic duct identified during the primary operation of choledochal cyst.
  
  
  METHODS
  Fourteen children were operated on for choledochal cyst. To identify the concurrent stenosis, cholangiography and inspection of the hepatic duct were performed during the operation. In those patients with identified membranous stenosis, the membrane was resected. In those with nonmembranous stenosis, the wide hilar hepaticojejunostomy was performed after hepatic duct plasty.
  
  
  RESULTS
  Eleven sites of hepatic duct stenosis were identified, 8 membranous stenoses and 3 relative stenoses without membrane. The membranous stenoses were classified into 4 subtypes as follows: a small central opening, a marginal opening, 2 openings, and a bridgelike structure. At the primary surgery on choledochal cyst, those stenoses were released, and the formation of the gallstone has not been observed in 4 to 11 years in all cases.
authors.affiliation: Department of Pediatric Surgery, Ibaraki Children's Hospital, Mito 311-4145, Japan.
authors.forename: Hisao
authors.initials: H
authors.lastname: Kemmotsu
authors.forename: Takeshi
authors.initials: T
authors.lastname: Mouri
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Muraji
mesh_terms: D002648:Child; D002675:Child, Preschool; D002758:Cholangiography; D015529:Choledochal Cyst / Q000473:pathology / Q000601:surgery*; D005260:Female; D006500:Hepatic Duct, Common / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D008297:Male; D013536:Suture Techniques