Surgical Treatment Of Adult Congenital Choledochal Cysts

Objective To study the clinical diagnosis and surgical treatment of adultcongenital choledochal cysts,this paper analyzes surgical treatment ofthe recent and forward curative effect and the reasons of reoperation,for better treatment of adults with bile duct diseases to provide certainreference value.Methods A retrospective analysis of surgical treatment of58cases ofadult congenital choledochal cysts in Union hospital affiliated to fujianmedical university from January2007to June2013, all the cases wereconfirmed diagnosis through imagine test such as B ultrasonic, CT, ERCP,MRCP imaging and postoperative pathologic diagnosis.Accordance to Todanitype,44cases of type I,12cases of type IVa,2cases of type IVb, nopatients with other types. Treatment: During the procedure common bileduct cyst resection+anastomosis of hepatic duct jejunum Roux-en-Y in47cases,2cases were merged small bowel resection because of the smallintestine diverticulum and heterotopic pancreas; Cyst partial resection+cyst jejunum Roux-en-Y anastomosis in1case. Line of common bile ductcyst resection and anastomosis of hepatic duct jejunum Roux-en-Y+lefthepatic lobectomy in8cases; common bile duct cyst resection+ofpancreaticoduodenal resection in1case, regularity left liver resection+common bile duct cyst excision+pancreaticoduodenal resection in1case.Results3cases of postoperative bile leakage,1case of incisioninfection,2cases of postoperative bleeding,2cases recovered afterconservative treatment; Pulmonary infection in3cases, intestinal floraimbalance in1case; Postoperative pathology:3cases of low level intraepithelial neoplasia,3cases of cancer; Postoperative follow-upof9months to7years, follow-up of58cases,3were lost to follow-up,2cases with biliary infection.3cases of primary biliary tumor,1casesrecurrenced after22months,29months postoperatively alive, the rest2cases alive, Bile duct complications such as biliary tractinfection,biliary stone,anastomotic stenosis, biliary tumor were notfound in Other cases.Conclusion Patients require surgical treatment of congenital bile ductcysts. The purpose of surgery is the complete resection of the cyst andBiliopancreatic Diversion；The selection of operation methods accordingto different types of pathological characteristics. A standard operationperiod is complete, as far as possible to avoid reoperation.