Castro MA, Ayala AM, Palacio VF, Vargas ÁAL

Language: Spanish
References: 8
Page: 120-123
PDF size: 81.77 Kb.

ABSTRACT

Adenocarcinoma case of choledochal cyst with duodenal invasion, 16 years surveillance. Literature revision. Background: Choledochal cysts are more common in women; 20% diagnosed in adults. The most common ones are I and IV (Todani). There is a relation with lithiasis in cyst, calculous cholecystitis; pancreatitis and cancer; with prevalent in type I and IV (57% is intracystic). From unknown etiology, diagnostic is clinic with USG, ERCP, resection treatment with biliodigestive reconstruction, a rare long-term surveillance. Description: 41 years old woman with acute abdomen, operated on November 1991 finding: chronic calculous cholecystitis, biliary dilatation due to choledocholithiasis. The surgery was cholecystectomy, biliar exploration and choledocho-duodenostomy anastomosis. Reentered June 1992, with acute abdomen and jaundice. USG and CPRE are performed, upholding cyst type I. Operated on finding: choledochal saccular, internal polypoid tumor and choledochoduodenostomy with stenosis. The treatment: cystic resection with «Y»of Roux rebuilt and catheter placement. Chemotherapy at month altogether with USG, TAC and scintigran with ⁹⁹Tc-IDA. No tumor activity currently. Conclusion: Surveillance is a long-term rare. Resection with chemotherapy might rise or diminish the recidivium.

REFERENCES

1. Alonso-Lej F, Reser WB Jr, De Pessagno DJ. Congenital choledochal cyst. With a report of two and an analysis of 94 cases (International Abstracts of Surgery). Surg Gynecol Obstet 1959; 108: 1-30.

2. Douglas AH. Case of dilation of the common bile duct Monthly. J Med Soc (London) 1852; 14: 97-100.

3. Flanigan PD. Biliary cysts. Ann Surg 1975; 182: 635-43.

4. Todani T, Watanabe Y, Nurse M et al. Congenital bile duct cysts. Classification, operative procedures, and review of thirty-seven cases including cancer arinsing from choledochal cyst. Am J Surg 1977; 134: 263-269.

5. Todani T, Watanabe Y, Tokio A, Urushihara. Drainage operation. Surg Gynecol Obstet 1987; 164: 61-64.

6. Nagorney DM, Mcllrath DC, Adson MA. choledochal cysts in adults. Clinical Management Surgery 1984; 96: 656-663.

7. Ono J, Sakoda, Akita H. Surgical aspect of cystic dilation of the bile duct. An anomalous junction of the pancreatobiliary tract in adults. Annals of Surgery 1982; 195: 203-208.

8. Voyles CR, Smadja C, Shands WC, Blumgart LH. Carcinoma of choledochal cysts. Age related incidence. Arch Surg 1983; 118: 986-988.