Diagnosis and management of giant choledochal cysts: Complexities compared to smaller cysts

被引：14
作者：
Anand U. [1 ]
Priyadarshi R.N. [2 ]
Kumar B. [3 ]
Khandelwal C. [4 ]
机构：
[1] Department of Gastrointestinal Surgery, Indira Gandhi Institute of Medical Sciences, Patna, 800 020, Sheikhpura
[2] Department of Radiodiagnosis, Indira Gandhi Institute of Medical Sciences, Patna, 800 020, Sheikhpura
[3] Department of Pediatric Surgery, Indira Gandhi Institute of Medical Sciences, Patna, 800 020, Sheikhpura
[4] Bihar Institute of Gastroenterology, Patna
来源：
Indian Journal of Gastroenterology | 2013年 / 32卷 / 4期
关键词：
Biliary disease; Biliary surgery; Congenital anomalies;
D O I：
10.1007/s12664-013-0335-0
中图分类号：
学科分类号：
摘要：
Background: This study presents our 11-year surgical experience with choledochal cysts (CDC), focusing on the complexity in the diagnosis and management of large-size CDCs. Methods: Medical records of 70 patients who underwent surgery for CDC between 2000 and 2011 were retrospectively reviewed. Of them, ten patients were found with cyst size >10 cm (group A), and we compared the differences in the clinical presentation, radiological diagnosis and surgical management with those with cysts ≤10 cm in size (group B). Results: Abdominal pain and lump were noted in all group A patients, but only 67 % and 14 % in group B patients, respectively. Sixty percent of group A, but only 14 % of group B patients, had a triad of abdominal pain, mass and jaundice. Cholangitis was more common in group A patients. Most of group B patients were correctly diagnosed with ultrasound alone, but misdiagnosis occurred more frequently in group A. Magnetic resonance cholangiopancreatography correctly achieved the diagnosis in all. Operative time (5 vs. 3 h) and blood loss (300-500 vs. 50-100 mL) were more in group A in comparison to group B. Conclusions: The clinical presentation and surgical management of giant choledochal cysts differ from their smaller counterparts. Diagnostic dilemma was common with giant CDC especially with ultrasound and CT. © 2013 Indian Society of Gastroenterology.
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页码：262 / 267
页数：5
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