Surgical Treatment of Congenital Choledochal Cyst (Report of 145 Cases)_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

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epartment of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu 610041;

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Keywords：

Congenital choledochal cyst; Operation; Biliary tract reconstruction; Intussusceptive valve

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Objective To present the surgical treatment experiences of congenital choledochal cyst (CCC). MethodsOne hundred and fortyfive patients in 152 CCC were analyzed retrospectively and followed in west China hospital of Sichuan university from 1964 to 1999. ResultsOne hundred and fortyfive cases underwent operation and 6 of them died after operation. The incidence of hepatocirrhosis within first year after birth is higher than those over one year old （P＜0.05）. Thirtynine cases underwent cystoduodenostomy or cystojejunostomy. One hundred and six children underwent cyst resection and biliary tract reconstruction (with single RouxY hepaticojejunostomy 48 cases, intussusceptive valve and rectangular valve to the line of RouxY hepaticojejunostomy 37 and 21 cases respectively). Seventyseven patients were followedup (means 4.68 years). Two of 3 cases with ascending cholangitis after single RouxY hepaticojejunostomy underwent reoperations with an intussusceptive valve added to the line of RouxY hepaticojejunostomy and the symptoms disappeared. All of them have a good outcome. Conclusion The younger the patients, the less severe the liver damaged, and its prognosis are better. The procedure that cyst resection totally and an intussusceptive valve added to the line of RouxY hepaticojejunostomy should be carried out early as soon as possible.

Citation： WU Xuedong,HU Tingze,FENG Jiexiong,et al. Surgical Treatment of Congenital Choledochal Cyst (Report of 145 Cases). CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2002, 9(2): 83-85. doi: Copy

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1. 赵莉,李振东,尹济群.胆总管囊肿手术前后血清酶学变化及其临床意义 \[J\].中华小儿外科杂志，1999； 20（3）∶178.
2. Hsu CC, Lin LH, Chen DF. Choledochal cyst in infancy: report of two cases \[J\]. Chung Hua Min Kuo Hsiao Erh Ko I Hsueh Hui Tsa Chih, 1997; 38(4)∶300.
3. 胡廷泽. 胆总管囊性扩张症 \[J\]. 中国实用内科杂志，1998； 18（7）∶396.
4. 王慧贞，黎明，李心元,等. 先天性胆总管囊性扩张症伴胰胆合流异常的诊断及治疗 \[J\]. 中华小儿外科杂志，1992； 13（4）∶195.
5. Farello GA, Cerofolini A, Rebonato M, et al. Congenital choledochal cyst: videoguided laparoscopic treatment \[J\]. Surg Laparosc Endosc 1995; 5(5)∶354.
6. Bismuth H, Krissat J. Choledochal cystic malignancies \[J\]. Ann Oncol, 1999; 10(Suppl 4)∶94.
7. Fujisaki S, Akiyama T, Miyake H, et al. A case of carcinoma associated with the remained intrapancreaticobiliary tract 17 years after the primary excision of a choledochal cyst \[J\]. Hepatogastroenterology, 1999; 46(27)∶1655.
8. Chapman RW. Risk factors for biliary tract carcinogenesis \[J\].Ann Oncol,1999; 10（Suppl 4）∶308.
9. 李福玉，胡廷泽,郎诗民. 小儿先天性胆总管囊肿的疗效分析 \[J\]. 四川医学，1990； 11（1）∶21.
10. 郎诗民，胡廷泽，钟麟. 套叠瓣预防胆肠RouxY吻合术后逆行性感染 \[J\]. 中华小儿外科杂志，1996； 17（4）∶207.
11. 姜月平.先天性胆总管囊肿手术治疗的探讨 \[J\].中华小儿外科杂志，1999； 20（3）∶180.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Surgical Treatment of Congenital Choledochal Cyst (Report of 145 Cases)

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