Open AccessManagement of Congenital Choledochal Cyst with Intrahepatic Involvement
Author(s) -
Takuji Todani,
Mitsuo Narusue,
Yasuhiro Watanabe,
Katsusuke Tabuchi,
Kunio Okajima
Publication year - 1978
Publication title -
annals of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.153
H-Index - 309
eISSN - 1528-1140
pISSN - 0003-4932
DOI - 10.1097/00000658-197803000-00011
Subject(s) - medicine , choledochal cysts , porta hepatis , cyst , intrahepatic bile ducts , hepatectomy , abdominal pain , intrahepatic cholangiocarcinoma , surgery , biliary tract , abdominal mass , incidence (geometry) , radiology , general surgery , gastroenterology , resection , bile duct , physics , optics
The clinical features and surgical treatment of 75 patients with choledochal cysts with intrahepatic involvement (Type IV-A) were evaluated. Seventeen were in this series and 58 were reviewed from the literature. It was of interest that the incidence of Type IV-A choledochal cysts was nearly 30%, considerably higher than had been previously assumed. This type is commonly found in older children and young adults. Abdominal pain and fever indicative of biliary tract infection are more frequent seen than in patients with Type I, and a mass is not commonly palpable. Surgical treatment of Type IV-A must achieve bile drainage from the intrahepatic cysts as well as from the choledochal cyst. For this reason, as well as the prevention of later development of cancer in the wall of the cyst, hepaticoenterostomy at the porta hepatis with partial resection of the wall of the intrahepatic cyst (or partial hepatectomy if possible) combined with excision of the intrahepatic cyst is recommended as the procedure of choice for type IV-A cysts.