Entrar/Registro  
HOME SPANISH
 
Cirugía y Cirujanos
   
MENU

Contents by Year, Volume and Issue

Table of Contents

General Information

Instructions for Authors

Message to Editor

Editorial Board






>Journals >Cirugía y Cirujanos >Year 2010, Issue 1


Martínez-Ordaz JL, Niño-Solís J
Quistes de colédoco en adultos
Cir Cir 2010; 78 (1)

Language: Español
References: 37
Page: 61-66
PDF: 239.57 Kb.

[Full text - PDF]

ABSTRACT

Background: Choledochal cysts are usually diagnosed during childhood. They mainly affect females. Abdominal pain and jaundice are the two most common symptoms. Our objective was to report the experience of a third-level referral center in the management of choledochal cysts in adults.
Methods: We performed a 17-year retrospective review of patients with choledochal cysts who underwent surgical interventions in a gastrointestinal surgery department.
Results: There were 23 patients with a median age of 26 years; 16 were females. The most frequent symptoms were abdominal pain and jaundice. Only four patients had an abdominal mass. The most frequently used diagnostic studies were abdominal sonography and endoscopic retrograde cholangiopancreatography. According to the classification of Todani, most cysts were type I and were found in 17 patients, two patients had type II, three patients had type III (choledocele) and one patient had type IVA. Eighteen patients underwent complete removal of the cyst with a concomitant hepatic-jejunostomy, three patients had transduodenal sphincteroplasty and two patients had only cystectomy. Seven patients developed postoperative complications, representing a morbidity rate of 35%. None of the patients died during the first 30 postoperative days. Cholangiocarcinoma was found in the resected specimen in only one case.
Conclusions: The surgery of choice for choledochal cysts in the adult is hepatic-jejunostomy, which has a low surgical morbidity and mortality.


Key words: Choledochal cyst, bile duct diseases.


REFERENCES

  1. Todani T, Watanabe Y, Narusue M, Tabuchi K, Okajima K. Congenital bile duct cysts. Classification, operative procedures, and review of thirty-seven cases including cancer arising from choledochal cyst. Am J Surg 1977;134:263-269.

  2. Todani T, Watanabe Y, Toki A, Urushihara N. Carcinoma related to choledochal cysts with internal drainage operations. Surg Gynecol Obstet 1987;164:61-64.

  3. Lenriot JP, Gigot JF, Segol P, Fagniez PL, Fingerhurt A, Adloff M. Bile duct cysts in adults. A multi-institutional retrospective study. Ann Surg 1998;228:159-166.

  4. Chijiiwa K, Koga A. Surgical management and long-term follow-up of patients with choledochal cysts. Am J Surg 1993;165:238-242.

  5. Deziel DJ, Rossi RL, Munson JL, Braash JW, Silverman ML. Management of bile duct cysts in adults. Arch Surg 1986;121:410-415.

  6. Stain SC, Guthrie CR, Yellin AE, Donovan AJ. Choledochal cyst in the adult. Ann Surg 1995;222:128-133.

  7. Lipsett PA, Pitt HA, Colombani PM, Boitnott JK, Cameron JL. Choledochal cyst disease. A changing pattern of presentation. Ann Surg 1994;220:644-652.

  8. Chaudhary A, Dhar P, Sachdev A, Kumar N, Vij JC, Sarin SK, et al. Choledochal cysts differences in children and adults. Br J Surg 1996;83:186-188.

  9. Metcalfe MS, Wemyss-Holden SA, Maddern GJ. Management dilemmas with choledochal cysts. Arch Surg 2003;138:333-339.

  10. Alonso-Lej F, Rever WB Jr, Pessagno DJ. Congenital choledochal cyst, with a report of 2 and an analysis of 94 cases. Int Abstr Surg 1959;108:1-30.

  11. Kasai M, Asakura Y, Taiba Y. Surgical treatment of choledochal cyst. Ann Surg 1970;172:844-851.

  12. Hopkins NFG, Benjamin IS, Thompson MH, Williamson RCN. Complications of choledochal cysts in adulthood. Ann R Coll Surg Eng 1990;72:229-235.

  13. Watanabe Y, Toki A, Todani T. Bile duct cancer developed after cyst excision for choledochal cyst. J Hepatobiliary Pancreat Surg 1999;6:207-212.

  14. Robertson JFR, Raine PAM. Choledochal cyst: a 33 year review. Br J Surg 1988;75:799-801.

  15. Jesudason SRB, Kuruvilla R, Govil S, Muthusami JC, Mathai V. Choledochal cysts in adults. Ann R Coll Surg Engl 1997;79:410-413.

  16. Fieber, SS, Nance FC. Choledochal cyst and neoplasm: a comprehensive review of 106 cases and presentation of two original cases. Am Surg 1997;63:982-985.

  17. Seung-Yeun R, Stovroff MC, Glick PL, Allen JE, Ricketts RR. Choledochal cysts: a ten year experience. Am Surg 1996;62:30-34.

  18. Olbourne NA. Choledochal cysts. A review of the cystic anomalies of the biliary tree. Ann R Coll Surg Eng 1975;56:26-32.

  19. Weyant MJ, Maluccio MA, Bertagnolli MM, Daly JM. Choledochal cysts in adults. A report of two cases and review of the literature. Am J Gastroenterol 1998;93:2580-2583.

  20. Hewitt PM, Krige JEJ, Bornman PC, Terblanche J. Choledochal cyst in adults. Br J Surg 1995;82:382-385.

  21. Park DH, Kim MH, Lee SK, Lee SS, Choi JS, Lee YS, et al. Can MRCP replace the diagnostic role of ERCP for patients with choledochal cysts? Gastrointest Endosc 2005;62:360-366.

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

  23. Spitz L. Choledochal cyst. Surg Gynecol Obstet 1978;147:444-452.

  24. Cárdenas SS. Los quistes de las vías biliares y su tratamiento. Rev Gastroenterol Mex 1992;57:153-154.

  25. Kobayashi S, Asano T, Yamasaki M, Kenmochi T, Nakagohri T, Ochiai T. Risk of bile duct carcinogenesis after excision of extrahepatic bile duct in pancreatobiliary maljunction. Surgery 1999;126:939-944.

  26. Rattner DW, Schapiro RH, Warshaw AL. Abnormalities of the pancreatic and biliary ducts in adult patients with choledochal cysts. Arch Surg 1983;118:1068-1073.

  27. Todani T, Watanabe Y, Fujii T, Toki A, Uemura S, Koike Y. Congenital choledochal cyst with intrahepatic involvement. Arch Surg 1984;119:1038-1043.

  28. Todani T, Watanabe Y, Toki A, Ogura K, Wang ZQ. Co-existing biliary anomalies and anatomical variants in choledochal cyst. Br J Surg 1998;85:760-763.

  29. Arenas-Márquez H, López-Neblina F, Anaya-Prado R, Gutiérrez-de la Rosa JL, Lua T. Revisión y corrección quirúrgica de quistes del colédoco. Rev Gastroenterol Mex 1992;57:157-160.

  30. Liu CL, Fan ST, Lo CM, Lam CM, Poon RT, Wong J. Choledochal cysts in adults. Arch Surg 2002;137:465-468.

  31. Nicholl M, Pitt HA, Wolf P, Cooney J, Kalayoglu M, Shilyansky J, et al. Choledochal cysts in western adults: complexities compared to children. J Gastrointest Surg 2004;8:245-252.

  32. Macfarlane JR, Glenn F. Carcinoma in choledochal cyst. JAMA 1967;202:1003-1006.

  33. Tsuchiya R, Harada N, Ito T, Furukawa M, Yoshihiro I, Kusano T, et al. Malignant tumors in choledochal cysts. Ann Surg 1977:186:22-28.

  34. Visser BC, Suh I, Way LW, Kang SM. Congenital choledochal cysts in adults. Arch Surg 2004;139:855-860.

  35. Plata-Muñoz JJ, Mercado MA, Chan C, González QH, Orozco H. Complete resection of choledochal cyst with Roux-en-Y derivation vs. cystenterostomy as standard treatment of cystic disease of the biliary tract in the adult patient. Hepatogastroenterology 2005;52:13-16.

  36. Chaudhari A, Dhar P, Sachdev A. Reoperative surgery for choledochal cysts. Br J Surg 1997;84:781-784.

  37. Woon CY, Tan YM, Oei CL, Chung AY, Chow PK, Ooi LL. Adult choledochal cysts: an audit of surgical management. ANZ J Surg 2006;76:981-986.






>Journals >Cirugía y Cirujanos >Year 2010, Issue 1
 

· Journal Index 
· Links 
       
Copyright 2010