CHOLEDOCHAL CYST

RECENT EXPERIENCE

Abstract

O BJECTIVES: To evaluate clinical presentation, morphology, associated hepatobiliary problems and results
of surgical excision of choledochal cyst. PATIENTS AND METHODS: Eight patients underwent surgery for
choledochal cysts between Nov 2000 to Nov 2001 in Bangabandhu Sheikh Mujib Medical University Hospital,
Shahbag, Dhaka Bangladesh. The diagnosis of choledochal cyst was based on clinical presentation, USG, radiological and operative findings. RESULTS: Total of 8 patients with choledochal cyst were identified. 7 patients were female and 1 was male. Age range was between 12 to 55 years. Presenting symptoms were episodic abdominal pain in 8 (100%), intermittent jaundice in 4 (50%), jaundice and fever in 3 (37.5%) and abdominal lump in 2 (37.5%) patients. LFT and USG were the initial diagnostic procedures in all patients, followed by ERCP in 4 (50%) and CT in 5 (62%) cases, MRCP in 1 (12.5%) case. Based on USG and Radiological imaging, cysts were classified according to Rodani’s classification. Out of eight, 7 (87.5%) were type I and 1 (12.5%) was type IVA. 5 (62.5%) patient had surgical excision and Roux-en-y hepatico-jejunostomy, 1 (12.5%) had cysto-duodenostomy, 1 (12.5%) per-cutaneous drainage of cyst and one patient (12.5%) with type IVA under went excision of extra hepatic cyst and hepaticojejunostomy and one patient died before definitive operation due to liver failure. CONCLUSIONS: Choledochal cyst is uncommon cause of bile duct obstruction. Type I is the commonest presentation and recognized treatment is the total excision of cysts with Roux-en-y hepatico-jejunostomy.