| Purpose: To compare the clinical characteristics and surgical outcomes of infants with choledochal cysts(CC)to those of older children with these entities and to establish the optimal management plan.Methods: Between June 2014 and July 2018,the medical records of 162 patients had CC were retrospectively reviewed.The patients were divided into two groups according to age at the time of presentations: <1 year old(infants,n= 38),and 1-16 years old(older children,n=134).The patient demographic,clinical data,operative findings,complications,and follow-up were collected and analyzed.Results: Abdominal pain was the most common presenting symptom(58.88%),followed by jaundice(14.20%)and vomiting(13.58%).Most(78.23%)patients in the older children group,but none in the infant group,presented with abdominal pain.jaundice were present about half of patients in the infant group but only 4.03% of those in the older children group.Liver function tests showed that serum bilirubin,aspartate aminotransferase(AST)and ?-glutamyl transpeptidase(GGT)levels in the infant group were more elevated than those in the older children group.Ten of the 162 patients in our series had a spontaneous perforation of the CC.The incidence of this complication is higher in the infant group than older children group.There were no intraoperative complications.The postoperative hospital stay were significantly shorter in the older children group(P<0.05).There were three postoperative early complications.These included bile leakage,wound infection,and intraperitoneal hemorrhage.The three patients required reoperation,and all patients subsequently did well.Conclusion: Jaundice and vomiting were the most common presenting symptoms in infant,while abdominal pain was the commonest symptom in older children.The potential risks of live damage,bleeding tendency and rupture of the cyst have increased in infants.The results support a recommendation for early surgical intervention. |
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