A Clinical Analysis of Choledochal Cyst: Review of twenty three cases.
- Author:
Yeun Sik JANG
1
;
Jin Ho SONG
;
Eun Tack PARK
;
Youn Jae LEE
;
Sang Hyok LEE
;
Sang Yong SEOL
;
Jung Myung CHUNG
Author Information
1. Department of Internal Medicine, College of Medicine, Inje University, Pusan, Korea.
- Publication Type:Original Article
- Keywords:
Choledochal cyst;
Anomalous junction of the pancreatico-biliary ductal system;
Classification of choledochal cyst
- MeSH:
Busan;
Cholangiopancreatography, Endoscopic Retrograde;
Cholecystitis;
Choledochal Cyst*;
Classification;
Colonic Neoplasms;
Female;
Humans;
Internal Medicine;
Jaundice;
Male;
Mortality;
Sex Ratio;
Tomography, X-Ray Computed;
Ultrasonography
- From:Korean Journal of Gastrointestinal Endoscopy
1997;17(5):640-647
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Choledochal cyst is an unusual but serious condition which most commonly affects Oriental people. And it is an unusual entity that has increasingly been encountered by ultrasonography and computed tomography scan, even if the symptoms are variable. METHODS: We reviewed 23 patients with choledochal cyst who were treated at the Department of Internal Medicine, Pusan Paik Hospital from April, 1986 to April 1995. RESULTS: 1) Age ranged from 14 years to 73 years, and sex ratio was 1:1.4 in male vs female. 2) The durations of symptoms varied from 4 days to several years. 3) The major clinical symptoms were right upper quardrant pain in 19 cases, jaundice in 4 cases, abdominal mass in 2 cases. One case had all of above three symptoms. 4) The diagnostic tools were ultrasonography(USG) in l7 cases, ERCP in 11 cases, abdominal CT in 11 cases, PTC in 6 cases and oral GB in 1 case. The eight cases(61.5%) were confirmed as anomalous junction of the pancreaticobiliary ductal system(AJPBS) among the 13 cases who had performed ERCP. 5) The choledochal cysts were classified into type I to V according to the classification of Todani; Fifteen cases were type I, six cases type IVa, one case was type II and one case was type V, respectively. 6) Excision of choledochal cyst and Roux-en-Y hepaticojejunostomy was performed in 10 cases, and choledocho-jejunostomy in 4 cases, and Whipple's operation in 2 cases. 7) The associated diseases were CBD stone in 8 cases, cholecystitis in 6 cases, intrahepatic stone in 2 cases, GB cancer in 1 case, and colon cancer in 1 case. CONCLUSIONS: ERCP should be used when choledochal cyst is suspected by USG, aiming at demonstrating both AJPBS and enabling the morphologic classification. In addition, Surgical procedures including the excision of choledochal cyst and Roux-en-Y hepaticojejunostomy may be effective to reduce mortality and morbidity related to complication of choleclochal cyst.
