Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong.
J Pediatr Surg. 2009 Dec;44(12):2307-11. doi: 10.1016/j.jpedsurg.2009.07.071.
Choledochal cyst is usually diagnosed in childhood. Early treatment can prevent further complication. We report on our series of patients over the past 30 years.
A retrospective study was performed on all pediatric patients who presented with choledochal cyst from January 1978 to December 2008. The main outcome measures recorded were the clinical presentation, management, and long-term outcome of the patients.
Eighty-three patients presented to us during the caption period with a mean age at diagnosis of 45 months (0 month to 16 years). Diagnoses were made antenatally in 15 patients. The most common symptoms were abdominal pain (n = 39) and jaundice (n = 35). Seventy-five patients had surgery, in which 72 patients had resection of the cyst and Roux-en-Y hepaticojejunostomy. Ten were performed by laparoscopic means. We categorized the cysts based on the Todani classification. There was no mortality. No malignant change was documented. For those 4 who had Caroli disease, 2 underwent liver transplantation and 2 had hepatectomy. Overall early complication rate was 5.3% (4/75).
Complete excision of cyst with Roux-en-Y hepaticojejunostomy is the treatment of choice, and the late result is good. Laparoscopic surgery is feasible. Long-term follow-up is necessary. There is no evidence to suggest that some type IV cysts are the result of disease progression from type I cysts.
胆总管囊肿通常在儿童时期被诊断。早期治疗可以预防进一步的并发症。我们报告了过去 30 年来的一系列患者。
对 1978 年 1 月至 2008 年 12 月期间所有患有胆总管囊肿的儿科患者进行了回顾性研究。记录的主要观察指标是患者的临床表现、治疗和长期预后。
在这段时间内，83 名患者就诊，平均诊断年龄为 45 个月（0 个月至 16 岁）。15 名患者在产前做出诊断。最常见的症状是腹痛（n = 39）和黄疸（n = 35）。75 名患者接受了手术，其中 72 名患者进行了囊肿切除和 Roux-en-Y 肝肠吻合术。10 例采用腹腔镜方法。我们根据 Todani 分类对囊肿进行了分类。无死亡病例。未发现恶性病变。对于 4 例患有 Caroli 病的患者，2 例行肝移植，2 例行肝切除术。总的早期并发症发生率为 5.3%（4/75）。
完整切除囊肿并进行 Roux-en-Y 肝肠吻合术是首选治疗方法，且预后良好。腹腔镜手术是可行的。需要长期随访。没有证据表明某些类型 IV 囊肿是由 I 型囊肿进展而来的。
