No abstract

A young female who had undergone choledochal cyst excision as a child presented with retained stone in the remnant intrapancreatic choledochal cyst which caused acute pancreatitis. This case is being reported to emphasise the importance of excising the choledochal cyst through the entire dilated part and to report the possibility of patients having symptoms due to protein plugs or retained stone in the intrapancreatic remnant.

Management decisions are very crucial in these conditions since the etiology is benign and the patients are young with good life expectancy in contrast to malignancies where usually the aim of treatment is palliation. These strictures are ideally managed by an experienced hepatobiliary team which greatly improves patient outcomes. Objectives: To evaluate treatment modalities available for the management of BBS and to find the best possible approach. Methods: Clinical data of 38 patients who underwent treatment at our institute between 2012e017 were analysed retrospectively from a prospectively maintained database. All the patients had been managed in our institute which specializes in the management of hepatobiliary diseases. Results: 3 patients underwent Endoscopic cholangiopancreatography and stent placement (ERCP), and the rest underwent surgical biliary tract reconstruction with 9 patients doing so after failed ERCP. Patients who were referred early had better outcomes when compared to patients who were referred late. Conclusion: Early referral to a specialist hepatobiliary centre along with scrupulous use of imaging with surgical modality as the choice of management were related to better outcomes. Specialist management is recommended for the management of this condition.