Pancreaticoduodenectomy for choledochal cyst.
OBJECTIVE
Choledochal cyst (CDC) is a rare congenital cystic dilatation of the biliary system that can affect children and adults. Standard treatment for CDC includes surgical excision of the cystic bile duct with restoration of bilioenteric continuity by Roux-en-Y hepaticojejunostomy. In rare situations, however, surgical excision of a CDC may require pancreaticoduodenectomy (PD). The goal of this study was to identify instances where a PD may be deemed necessary.


METHODS
We retrospectively reviewed the medical records of all patients treated for CDC at our institution from January 1988 through December 2011. From this cohort, patients who underwent PD were reviewed in detail. Data on preoperative parameters, operative details, cyst type, pathologic diagnosis, and postoperative course were collected.


RESULTS
During the 24-year period, 59 patients with CDC were identified and four (7%) underwent formal PD. Final pathology revealed that none of the resected specimens harbored malignancy and all patients are well at follow-up.


CONCLUSIONS
While the standard surgical care for CDC remains complete cyst excision with Roux-en-Y hepaticojejunostomy, there may be particular instances where PD appears more appropriate. While the need for PD in cases of CDC is rare, it is important to consider this possibility when contemplating surgery for CDC.
Ross
R
Mazo
Alejandro R
AR
Ruiz-Elizalde
John A
JA
Chabot
Robert A
RA
Cowles
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D049448:Cholangiopancreatography, Magnetic Resonance; D015529:Choledochal Cyst / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D009519:New York City; D016577:Pancreaticoduodenectomy / Q000009:adverse effects; D018579:Patient Selection; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult