title: Choledochal cyst in childhood: review of 30 cases.
abstract: OBJECTIVE
  To analyze and discuss the clinical data, diagnosis and treatment of a number of patients with cystic dilatation of the common bile duct of a Brazilian pediatric hospital.
  
  
  METHODS
  We analyzed 30 patients treated at the Martagão Gesteira Institute of Pediatrics and Child Care of the Federal University of Rio de Janeiro for 23 years ,with statistical analysis of epidemiological data, clinical manifestations, diagnosis, treatment and postoperative outcome.
  
  
  RESULTS
  We observed a marked female predominance (73.4% of cases), the diagnosis being made in the first decade of life in 90% of patients. The most prevalent clinical manifestation was jaundice (70% of cases) and the classic triad of choledochal cyst was not observed. Abdominal ultrasound was the first imaging examination performed, with a sensitivity of 56.6%, with diagnostic definition in 17 children. Two patients (6.6%) had prenatal diagnosis. All patients underwent surgical treatment, cyst resection with Roux-en-Y hepaticojejunostomy being performed in 80% of cases. The incidence of postoperative complications was 13.3% and the mortality rate was 6.6%, ie two patients were diagnosed with Caroli's disease.
  
  
  CONCLUSIONS
  The non-observance of the classic triad of choledochal cyst suggests that its incidence is lower than that reported in the medical literature. The surgical treatment of choledochal cysts, with resection and bilioenteric anastomosis, is safe even for small children.
authors.affiliation: Federal University of Rio de Janeiro.
authors.forename: Danielle Nunes
authors.initials: DN
authors.lastname: Forny
authors.affiliation: Department of Surgery, Faculty of Medicine, UFRJ.
authors.forename: Saulo Marcos Rebello
authors.initials: SM
authors.lastname: Ferrante
authors.affiliation: Department of Surgery, Faculty of Medicine, UFRJ.
authors.forename: Vinícius Gomes da
authors.initials: VG
authors.lastname: Silveira
authors.affiliation: Department of Surgery, Faculty of Medicine, UFRJ.
authors.forename: Ivonete
authors.initials: I
authors.lastname: Siviero
authors.affiliation: Department of Pathology, UFRJ.
authors.forename: Vera Lucia Antunes
authors.initials: VL
authors.lastname: Chagas
authors.affiliation: Department of Surgery, Faculty of Medicine, UFRJ.
authors.forename: Ivens Baker
authors.initials: IB
authors.lastname: Méio
mesh_terms: D002648:Child; D002675:Child, Preschool; D015529:Choledochal Cyst / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies