Choledochal cysts surgical management: Retrospective and historical comparative analysis

Paula Pastor; Juan Ocaña; Alberto González; Jordi Nuñez; Alba García; Juan Carlos García; José María Fernández-Cebrián; Javier Nuño

doi:10.1016/j.ciresp.2020.10.003

Choledochal cysts surgical management: Retrospective and historical comparative analysis

Cir Esp (Engl Ed). 2021 Mar 10:S0009-739X(20)30318-3. doi: 10.1016/j.ciresp.2020.10.003. Online ahead of print.

[Article in English, Spanish]

Authors

Paula Pastor¹, Juan Ocaña², Alberto González², Jordi Nuñez², Alba García², Juan Carlos García³, José María Fernández-Cebrián², Javier Nuño²

Affiliations

¹ Sección de Hepatología, Departamento de Cirugía General y Digestiva, Hospital Universitario Ramón y Cajal, Madrid, España. Electronic address: paula-pastor@hotmail.com.
² Sección de Hepatología, Departamento de Cirugía General y Digestiva, Hospital Universitario Ramón y Cajal, Madrid, España.
³ Sección de Coloproctología, Departamento de Cirugía General y Digestiva, Hospital Universitario Ramón y Cajal, Madrid, España.

PMID: 33714555
DOI: 10.1016/j.ciresp.2020.10.003

Abstract

Introduction: Choledochal cysts are rare bile duct dilatations, which have higher prevalence in Asian population. The aim of the study was to analyze clinical and surgical results about biliary cysts management. In addition, a comparative historical analysis was performed.

Methods: Patients who underwent surgery between January 1988 and December 2019 in a single tertiary level center were retrospectively included. Demographic and clinical patient data; cyst types; diagnostic methods and surgical technique were analyzed, as well as short and long-term follow-up complications. A comparative descriptive study focus on the main historical series was also carried out.

Results: A total of seventeen patients were identified; 58.8% were men. The mean age at diagnosis was 39.9 years (SD: 20.54). The median follow-up was 5 years (IQR 1-15). The most frequent cysts were tipe I (41.2%). Abdominal pain was the most common presenting symptom (58.8%). Cystic excision with bilio-enteric anastomosis was the main procedure, it was underwent in 85, 7% type I cysts. 29.4% postoperative complications were recorded. Malignancy was not documented in any pathology specimen.

Conclusions: Choledochal cysts are an uncommon disorder whose diagnosis requires a high level of suspicion. Surgical treatment depends on type of cyst. In most patients with choledochal cysts disease, complete cyst excision with bilio-enteric anastomotic reconstruction is the treatment of choice.

Keywords: Anomalous pancreaticobiliary junction; Anomalía unión pancreatobiliar; Biliodigestive bypass; Cholangiocarcinoma; Choledochal cyst; Colangiocarcinoma; Derivación biliodigestiva; Quiste de colédoco.