The Surgical Treatment For Type Ⅰ Congenital Choledochal Dilatation(Analysis Of 49 Cases)

Objective: To investigate the presentation of typeâ… congenital choledochal dilatation, to conclude the experience of cyst excision with biliary reconstruction in the past 10 years.Methods: Forty-nine patients who were treated in the past 10 years were subdivided into two groups by age: the child group, less than 14 years (n=27); the adult group, greater than 14 years(n=22). 6 cases in the child group underwent jejunal interposion hepaticoduodenostomy with spur valve at the duodenal anastomosis. 21 cases in the child group underwent improved Roux-en-Y hepaticojejunostomy biliary reconstruction. 19 cases in the adult group underwent improved Roux-en-Y hepaticojejunostomy biliary reconstruction. 2 cases in the adult group underwent Roux-en-Y hepaticojejunostomy biliary reconstruction. In the postoperation during the recent and long term follow up different presentations are compared, the complications of each group are compared too.Results: Forty eight patients have been followed up during 10 years. The follow-up result shows that abdominal mass are prevailing in children while abdominal pain are prevailing in adults, In 6 cases who underwent jejunal interposion hepaticoduodenostomy with spur valve at the duodenal anastomosis, one was suffered from disruption of wound. In 21 cases who underwent improved Roux-en-Y hepaticojejunostomy biliary reconstruction, one was suffered from anastomic leakage. In 19 cases who underwent improved Roux-en-Y hepaticojejunostomy biliary reconstruction, two were suffered from recurrent cholangitis, five were suffered from intrahepatic bile duct stone. In 2 cases who underwent Roux-en-Y hepaticojejunostomy biliary reconstruction, both were suffered from recurrent cholangitis, one was suffered from intrahepatic bile duct stone.Conclutions: There is some difference in the presentation between the child group and the adult group. Our experience suggests that the improved Roux-en-Y hepaticojejunostomy with antireflux procedure is a reasonable method for the treatment of congenital choledochal dilatation.