Choledochal Cyst of the Cystic Duct – A Supplement to Todani's Classification

Sehgal, Mehak; Yadav, Devendra Kumar; Kandasamy, Devasenathipathy; Bajpai, Minu; Jain, Vishesh; Dhua, Anjan Kumar; Goel, Prabudh

doi:10.4103/jiaps.jiaps_139_20

Cited by 5 publications

(5 citation statements)

References 4 publications

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“…Esses cistos biliares podem ocasionar dilatação da árvore biliar tanto nas extensões intra, quanto extra-hepáticas isoladamente ou em ambas ao mesmo tempo (Tommolino, 2020). O ducto cístico normal mede entre 2 a 4 cm de comprimento e varia de 1 a 5 mm de diâmetro, sendo que o diâmetro do ducto cístico >5 mm e <10 mm é considerado uma dilatação leve no contexto desta doença (Sehgal et al, 2021). A expansão do diâmetro do ducto cístico nos pacientes acometidos por As manifestações das alterações citadas anteriormente e o diagnóstico é feito, na maioria das vezes, ainda na infância, entretanto, quando diagnosticadas em idade adulta, o quadro decorre de sintomas e sinais mais avançados da doença (Soares et al, 2014).…”

Section: Discussionunclassified

“…al. Brazilian Journal of Implantology and Health Sciences Volume 6, Issue 3 (2024), Page 475-488.essa condição pode resultar em agudização acentuada da angulação na junção do ducto cístico com o ducto hepático comum, o que pode contribuir com o redirecionamento de enzimas refluxadas para o ducto cístico(Sehgal et al, 2021). A etiologia não está bem esclarecida, mas a mais aceita atualmente é a proposta por Babitts em 1969, a qual aos tipos de apresentação da doença(Ye;Lui;Tam, 2022).…”

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Doença Cística das Vias Biliares do tipo IVa: Relato de Caso

Carraro,

Ortmann Strada,

Tureta Cagnini

et al. 2024

Braz. J. Implantol. Health Sci.

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A doença cística das vias biliares é uma anomalia congênita que pode acometer as vias biliares intra e/ou extra-hepáticas. A tríade clássica se apresenta como dor abdominal, icterícia e massa abdominal. Entretanto, o diagnóstico preciso é dificultado já que essa tríade se apresenta em apenas um terço dos pacientes, e também pelas alterações laboratoriais serem inespecíficas, podendo sugerir inúmeras doenças hepatobiliares. Métodos de imagem como a ultrassonografia (US) e a colangiopancreatografia por ressonância magnética (CPRM) são indicados para o diagnóstico precoce dos cistos para evitar possíveis complicações, além de serem úteis no plano cirúrgico. O relato de caso tem como objetivo a análise detalhada das condutas tomadas a partir do quadro clínico apresentado, através da observação do prontuário e entrevista à paciente. O caso clínico descreve uma paciente adulta do sexo feminino, que se apresentou com dor em hipocôndrio direito, icterícia, náuseas e vômitos. Os exames iniciais revelaram hiperbilirrubinemia, e a abordagem diagnóstica incluiu Tomografia de Abdome, US e Colangiopancreatografia Retrógrada Endoscópica (CPRE), resultando no diagnóstico de colecistite crônica e colelitíase. Após colecistectomia, desenvolveu bilioma infectado, tratado com drenagem percutânea e intervenção cirúrgica. Subsequentemente, apresentou colangite, sendo diagnosticada com doença cística das vias biliares do tipo IVa. Realizou drenagem biliar combinada e recebeu alta com encaminhamento para acompanhamento cirúrgico. Logo, o relato de caso demonstra a complexidade do manejo desta condição e a importância de realizar a investigação minuciosa para alcançar o correto diagnóstico a fim de fornecer o melhor tratamento possível e evitar maiores complicações.

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Section: Discussionunclassified

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Doença Cística das Vias Biliares do tipo IVa: Relato de Caso

Carraro,

Ortmann Strada,

Tureta Cagnini

et al. 2024

Braz. J. Implantol. Health Sci.

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“…Their clinical and histopathological features are consistent with CCs. Since the first report of a cystic duct cyst published by Stoppa et al in 1965, many followed, and Serradel et al designated them as a ‘‘type VI choledochal cyst” [ 22 , 23 ]. Cases of both solitary fusiform or saccular cystic duct dilations and cystic duct cysts associated with CCs in other locations have thereafter been described [ 24 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…Even in the absence of CCs, cholecystectomy and complete excision of the common bile duct are recommended in patients with APBDJ, given the significant risk of gallbladder cancer discussed above [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

The Curious Case of the Choledochal Cyst—Revisiting the Todani Classification: Case Report and Review of the Literature

et al. 2023

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Choledochal cysts (CCs) are rare occurrences presenting as dilatations of biliary structures, which can present as single or multiple dilatations and can appear as both intra- and extrahepatic anomalies. The most widespread classification of CCs is the Todani classification, but there have been numerous reports of cysts that do not fall into any of the types described. We present such a case—a male patient 36 years of age who underwent preoperative CT, MRCP, and ERCP, which mistakenly indicated a type II Todani CC, and intraoperatively was found to be located at the confluence of the hepatic ducts and encompassed the origin of the common bile duct. Complete resection of the cyst and the proximal segment of the common bile duct was performed, and reconstruction was carried out by Roux-en-Y double-tutorized hepaticojejunostomy. Considering the risk of malignant transformation, the frequent preoperative misdiagnosis, as well as the technically challenging surgery required in such cases, we advocate for a revision of the classification and raise awareness of the need for guidelines regarding the proper short-term and long-term management of this disease to ensure adequate quality of life and disease-free survival for patients.

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“…In most cases, the condition needs to be confirmed by intraoperative diagnosis [ 10–13 ]. With the development of medical technology and improvement of diagnosis and treatment mode, an increasing number of patients can obtain a correct diagnosis through MRI, MRCP, or ERCP to clarify the structure of the biliary system [ 1 , 2 , 10 , 14 ]. Cystic duct cysts are significantly different from gallbladder malformations such as double gallbladder in structure, and there is no independent duct connecting with the common bile duct [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

A new variant of Choledochal cyst-type VI: a rare case presentation and review of the literature

Bai,

Li,

Tang

et al. 2023

Journal of Surgical Case Reports

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A 53-year-old male patient with a previous diagnosis of dilatation of the common bile duct was admitted to the hospital due to recurrent episodes of vague epigastric pain over a 4-month period. After undergoing abdominal CT, MRI, MRCP, ERCP examinations, together with joint diagnosis by the radiology department and the gastroscopy unit, the diagnosis of a cystic dilatation of the common bile duct was excluded, and to preliminarily diagnose as cystic lesion at the hepatoduodenum ligament. A nasobiliary tube was preset before the surgery, and it was found that the gallbladder, the cyst, and the common bile duct were connected in sequence during the surgery, leading to the definitive diagnosis of biliary cyst of the cystic duct. During the surgery, the anatomical position of the common bile duct was accurately identified, avoiding iatrogenic biliary injury and preserving the integrity of the common bile duct structure. The patient recovered and was discharged from the hospital on the 14th postoperative day. Cystic duct cysts are a relatively new and rare condition. This case demonstrates that clinical decision-making by a multidisciplinary team is of great significance for such diseases, and preoperative assessment of the anatomical relationship between cystic dilation lesions in the hepatic portal region and the biliary system and gallbladder is also crucial.

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Choledochal Cyst of the Cystic Duct – A Supplement to Todani's Classification

Cited by 5 publications

References 4 publications

Doença Cística das Vias Biliares do tipo IVa: Relato de Caso

Doença Cística das Vias Biliares do tipo IVa: Relato de Caso

The Curious Case of the Choledochal Cyst—Revisiting the Todani Classification: Case Report and Review of the Literature

A new variant of Choledochal cyst-type VI: a rare case presentation and review of the literature

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