| 作者 |
Chung-Chou Juan, Tung-Kaung Yuan, Ching-Kuen Pan, Ming-Yan Yang, Hon-Yaw Chen, Yung-Fang Chuang, Chen-Guo Ker, Hoi-Wan Lo |
| 摘要 |
Choledochal cyst is typically a surgical problem of infancy or childhood, but some of them, the diagnosis is delayed until adulthood. Twenty-two adult patients with choledochal cysts were included in this study. Their ages ranged from 23 to 69 years. There were 9 male and 13 female. Todani's classification of choledochal cyst according to the cholangiographic study was used. Type I was found in 12 patients (57.1%), type II in 1 (4.8%), type IV-a in 7 (33.33%), and type IV-b in 1 (4.8%), There was no type IlI or V in our series. Sixteen patients had imaging studies and avaliable for investi-gating the anomalous junction of the bile duct and pancreatic duct. Nine (56.3%) had the C-P type, four (25%) had the P-C type and only three (18.7%) had the normal type. In our patients, the classic triad of pain was found in 17 (77%), jaundice in 6 (27%) and fever in 9 (41%), but no patient had all symptoms of this classic triad simultaneously. There were twenty patients had accepted removal of choledochal cyst and hepatico-jejunostomy Roux-en-Y anastomosis. One patient died postoperatively due to the leakage from the hepatico-jejunostomy and uncontrollable sepsis. A post-operative late follow-up study was performed and cholangitis was found in six patients (31.6%, 6/19); four without stone formation and anther two with stone formation in the intrahepatic ducts with one death. The definitive treatment of this disease is surgical excision of the cyst totally where possible. Because of the rist of post-operative recurrent cholangitis, and malignant changes in the long-term follow-up studies, periodic evaluation of the biliary tree with imaging diagnostic methods were recommended. |
