Influence of age on the presentation and outcome of choledochal cyst

Purpose: The aim of this study was to identify the most appropriate timing for surgery in newborns with choledochal cysts. Methods: The clinical and histological data of 8 newborn cases of choledochal cysts (newborn group) were compared with 45 cases that were diagnosed later than the newborn period (late group). Results: The mean and standard deviation of age at diagnosis was 0.4 +/- 0.4 months and 43.4 +/- 37.8 months in the newborn and late group, respectively. The age at operation was significantly earlier in the newborn group than in the late group (4.9 +/- 4.5 months v 54.7 +/- 47.0 months). Although no significant difference in the time that elapsed between the operation and the onset of symptoms between the newborn and late groups (4.5 +/- 4.7 months v 11.3 +/- 21.1 months), the serum bilirubin level (4.6 +/- 3.8 mg/dL v 1.8 +/- 3.4 mg/dL) and the grade of liver fibrosis (2.0 +/- 0.8 v 1.1 +/- 0.8) were significantly higher in the newborn group than in the late group. Conclusions The newborn group should be considered as a special group of patients with different clinical course and pathology than those of the late group, which necessitate the early surgical intervention to prevent progression of liver fibrosis. J Pediatr Surg 34:1765-1768. Copyright (C) 1999 by W.B. Saunders Company.