Schnettler R David, Norín M Janitza, López D Rafael
Facultad de Medicina, Universidad Católica del Maule, Talca, Chile.
Andes Pediatr. 2021 Aug;92(4):596-601. doi: 10.32641/andespediatr.v92i4.2995.
The choledochal cyst (also bile duct cyst) is a rare condition. It is important to know its clinical presentation, diagnosis, and treatment alternatives, which allow a resolution with low morbidity.
to report the clinical diagnosis together with the laparoscopic techniques for the mana gement of the bile duct cyst.
Case 1: 4-year-old preschooler with history of recurrent abdominal pain. Abdominal ultrasound showed a choledochal cyst. Blood amylase levels 111 IU / L. Other tests were normal. Case 2: 5-year-old preschooler with a 5-days history of abdominal pain, vomiting, and diarrhea. He was admitted due to acute pancreatitis (blood lipase 947 IU / L, blood amylase 217 IU / L). Abdominal CT scan reported a lobulated cystic lesion in the hilum of the liver. Case 3: 3-year-old preschooler with recurrent abdominal pain and a 3-day history of epigastric pain and vomiting. Blood amylase and lipase levels were 248 IU / L and 253 IU / L, respectively, diagnosing acute pancreatitis. Abdominal CT scan showed a finding suggestive of a common bile duct cyst. In all 3 cases, the magnetic resonance cholangiopancreatography reported a type I choledochal cyst. All pa tients underwent laparoscopic surgery, performing cyst resection, and hepaticoduodenostomy. One case presented pneumobilia without requiring specific management, the other two did not present incidents and all remain asymptomatic in the follow-up period that was longer than one year after surgery.
In the choledochal cyst, clinical suspicion and timely diagnosis with imaging studies and minimally invasive surgery are important, which allow optimal results in the medium- and long term.
胆总管囊肿（也称胆管囊肿）是一种罕见疾病。了解其临床表现、诊断方法及治疗选择很重要，这些能使病情以低发病率得到解决。
报告胆总管囊肿的临床诊断及腹腔镜治疗技术。
病例1：一名4岁学龄前儿童，有反复腹痛病史。腹部超声显示胆总管囊肿。血淀粉酶水平为111 IU/L。其他检查正常。病例2：一名5岁学龄前儿童，有5天腹痛、呕吐和腹泻病史。因急性胰腺炎入院（血脂肪酶947 IU/L，血淀粉酶217 IU/L）。腹部CT扫描报告肝脏门区有分叶状囊性病变。病例3：一名3岁学龄前儿童，有反复腹痛及3天上腹部疼痛和呕吐病史。血淀粉酶和脂肪酶水平分别为248 IU/L和253 IU/L，诊断为急性胰腺炎。腹部CT扫描显示有提示胆总管囊肿的表现。在所有3例病例中，磁共振胰胆管造影报告为I型胆总管囊肿。所有患者均接受了腹腔镜手术，进行囊肿切除及肝十二指肠吻合术。1例出现气腹，无需特殊处理，另外2例未出现并发症，在术后1年多的随访期内均无症状。
对于胆总管囊肿，临床怀疑、通过影像学检查及时诊断以及微创手术很重要，这能在中长期取得最佳效果。
