What is the treatment of choledochal cyst?

What is the treatment of choledochal cyst?

The treatment of choice for choledochal cysts is complete excision. Patients with type I, II, or IV cysts are recommended for surgical excision due to the risk of malignancy, if they are deemed good surgical candidates.

How is a choledochal cyst removed?

In both types of surgery for choledochal cysts, the cyst is removed and often the system of bile ducts are reconstructed or repaired using a section of intestine. Laparoscopy, a minimally invasive surgical technique, may be used to remove your child’s choledochal cyst.

What is the gold standard in the surgical management of choledochal cyst?

Choledochal cyst is a rare disease either in pediatrics or adults. In the most common type of CC, the surgical excision is the gold standard. The reconstruction of the biliary tract in the case of CC is not standardized.

What is Type 3 choledochal cyst?

Type III choledochal cysts are the least common biliary cyst subtype. They have a female predominance and are the most likely to present at an older age. The most common clinical presentation is acute pancreatitis. The overall incidence of adenocarcinoma is approximately 2.5%.

What is Type 4 choledochal cyst?

Background/purpose: Type IV-A choledochal cysts are characterized by congenital cystic dilatation of the biliary tree extending to involve the intrahepatic biliary channels also. A single-center experience of the management of type IV-A choledochal cysts is presented.

What is the most common type of choledochal cyst?

Type I cysts (see image below) are the most common and represent 80-90% of choledochal cysts. They consist of saccular or fusiform dilatations of the common bile duct, which involve either a segment of the duct or the entire duct. They do not involve the intrahepatic bile ducts.

How serious is choledochal cyst?

There is an increased risk of cancer in the wall of the cyst. In older individuals, choledochal cysts are more likely to cause abdominal pain and intermittent episodes of jaundice and occasionally cholangitis (inflammation within the bile ducts caused by the spread of bacteria from the intestine into the bile ducts).

Which type of choledochal cyst has highest risk of malignancy?

Patients with types I and IV choledochal malformation had an increased risk of malignancy (P = 0·016). Patients who underwent cystic drainage had an increased risk of developing biliary malignancy compared with those who had complete cyst excision, with an odds ratio of 3·97 (95 per cent c.i. 2·40 to 6·55).

What is CDC excision?

Background: Choledochal cyst (CDC) is a rare biliary disorder. Surgical treatment consists of CDC excision and biliary-enteric reconstruction. Recently, some institutions have reported successful CDC excision by using minimally invasive techniques.

What are the complications associated with choledochal cyst?

Adults with choledochal cysts can present with one or more severe complications – eg, liver abscesses, cirrhosis, portal hypertension, recurrent pancreatitis, gallstones, cholangiocarcinoma. About 1-12% of patients present with spontaneous rupture and symptoms and signs of abdominal pain, sepsis and peritonitis.

What is Type 1 choledochal cyst?

Type 1 — a cyst of the extrahepatic bile duct, accounting for up to 90% of all choledochal cysts. Type 2 — an abnormal pouch or sac opening from the duct. Type 3 — a cyst inside the wall of the duodenum. Type 4 — cysts on both the intrahepatic and extrahepatic bile ducts.

Which type of jaundice is observed in choledochal cyst?

Jaundice in choledochal cyst is often intermittent because the obstruction is rarely complete unlike in biliary atresia. Character of jaundice is an important ominous symptom in differentiating obstructive jaundice due to biliary duct cystic dilatation from obstructive jaundice due to biliary atresia.

Is a choledochal cyst life threatening?

As the cysts are difficult to eradicate short of total excision and liver transplantation, these complications tend to be lifelong and may progress to liver abscess and life-threatening sepsis.

What is Roux en Y Hepaticojejunostomy?

What is hepaticojejunostomy? A hepaticojejunostomy, or Roux-en-Y procedure, bypasses the bile duct to allow digestive juices to drain from the liver directly into the small intestine. The hepatic duct is the tubular channel that carries bile from the liver to the small intestine to aid digestion.

What causes choledochal cyst?

Researchers believe that choledochal cysts form when there is an abnormality at the intersection between the bile duct and pancreatic duct. This abnormal connection forces pancreatic juice to flow backward into the bile duct and may cause cysts to form.

What is HJ surgery?

A hepaticojejunostomy is the surgical creation of a communication between the hepatic duct and the jejunum; a choledochojejunostomy is the surgical creation of a communication between the common bile duct (CBD) and the jejunum.

What is Braun anastomosis?

Braun enterostomy is a type of anastomosis done following a major surgery like pancreaticoduodenectomy (removal of pancreas and a part of the intestine). Enteroenterostomy is an anastomosis (connection) between one part of the small bowel to another (jejunum or ileum).

Why Roux-en-Y is done?

Gastric bypass is done to help you lose excess weight and reduce your risk of potentially life-threatening weight-related health problems, including: Gastroesophageal reflux disease. Heart disease. High blood pressure.