CHOLEDOCAL DISEASE MANAGEMENT: TEN YEARS INSTITUTIONAL EXPERIENCE | ||||
| The Egyptian Journal of Surgery | ||||
| Volume 32, Issue 4, October 2013, Page 248-255 PDF (781.18 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejsur.2013.366717 | ||||
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| Authors | ||||
Osama Hegazy  ; Hany Shoreem; Khaled Abuelella; Tarek Ibrahim
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| Department of HBP & Liver Transplantation Surgery, National Liver Institute, Menoufiya University, Egypt | ||||
| Abstract | ||||
| Background: Choledocal cysts are congenital anomalies of the bile ducts. 60% of patients are diagnosed during first decade of life; about 20% go undiagnosed until adulthood. Patients and Methods: seventy patients with CC disease had been managed between 2001 and 2011 at National Liver Institute, Menoufiya University, Egypt. Retrospective analysis of their records performed to evaluate types, frequency, presentation, management and outcome of choledocal disease. Results: Pediatrics (< 2years) were 30 patients (43%), Pediatrics (> 2 years) were 16 patients (23%), & adults were 24 patient (34%). Type I was recorded in 55 cases (79%), type II in 3 cases (4%), type III in 2 cases (3%), type IV in 3 cases (4%) and type V in 7 cases (10%). Complete cyst excision with HJ had been performed in 82.5%, excision with primary closure of CBD in 4%, left hepatectomy in one case, right hepatectomy in 2 cases and non-operative management in 6 cases (8.5%). Postoperative bile leak occurred in 4%, biliary stricture in 7% with intrahepatic stones in 2.4%. The overall mortality was 8.5% and all were from the pediatric group. Conclusion: Choledocal disease requires proper diagnosis and treatment to address associated symptoms, risk of malignancy, and disease progression. The presentation of CC varies between different age groups. MRCP is mandatory and could be sufficient in the diagnosis. The majority of cases of biliary cysts (type I and IVA) can be treated effectively with cyst resection and biliary reconstruction. | ||||
| Keywords | ||||
| Choledocal disease; Choledocal cyst; Caroli's disease; biliary cysts | ||||
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