Abstract
To evaluate late results in children who had been treated with an internal drainage procedure for a choledochal cysts, we carried out follow-up examinations and performed endoscopic retrograde cholangiopancreatography (ERCP). Internal drainage procedures were performed on a total of 17 patients prior to 1972. The follow-up period ranged from 18 to 30 years. ERCP was performed on 8 of 10 patients followed up. All had dilatation of the common bile duct; 7 had an anomalous pancreatobiliary junction; and there were no carcinomas detected. The procedures consisted of choledochocystoduodenostomy (CCD) in 12 patients, choledochocystojejunostomy (Roux-Y) (CCJRY) in 4, and cholecystoduodenostomy (CYD) in 1. Of the 12 patients who were treated with CCD, 3 were lost to follow-up, 3 died of liver cirrhosis, and 6 survived. Five of the 6 surviving patients needed a reoperation for cholangitis; in 1 of these severe atypical abnormalities of the cyst were found on pathologic examination. Of the 4 patients who were treated with CCJRY, 1 died of liver cirrhosis but the 3 survivors had an asymptomatic postoperative course common bile duct and an anomalous pancreatobiliary junction noted during the current work-up. The patient who was treated with CYD needed another operation for choledocholithiasis. Our conclusions for following patients who were treated with an internal drainage procedure in childhood are twofold: (1) for patients who had CCD, cyst excision is recommended; and (2) for patients who had CCJRY performed at the age of 10 years or less, cautious observation is recommended as long as the patient remains asymptomatic.
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References
Flanigan DP (1975) Biliary cyst. Ann Surg 182: 635–643
Powell CS, Sawyers JL (1981) Management of adult choledochal cysts. Ann Surg 193: 666–676
Takiff H, Stone M (1985) Choledochal cysts: results of primary surgery and need for reoperation in young patients. Am J Surg 150: 141–146
Todani T, Watanabe Y (1987) Carcinoma related to choledochal cysts with internal drainage operations. Gynecol Obstet 164: 61–64
Voyles CR, Smadja C (1983) Carcinoma in choledochal cysts, age-related incidence. Arch Surg 118: 986–988
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Naito, M., Iwafuchi, M., Ohsawa, Y. et al. Late follow-up following internal drainage of choledochal cysts reassessment of necessity for reoperation. Pediatr Surg Int 7, 282–283 (1992). https://doi.org/10.1007/BF00183981
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DOI: https://doi.org/10.1007/BF00183981