Clinical characteristics of liver fibrosis in patients with choledochal cysts

Fujishiro, Jun; Urita, Yasuhisa; Shinkai, Toko; Gotoh, Chikashi; Hoshino, Naomi; Ono, Kentaro; Komuro, Hiroaki

doi:10.1016/j.jpedsurg.2011.09.017

Cited by 19 publications

(9 citation statements)

References 13 publications

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“…In our study, the hepatic pathological results mentioned above assumed a delay of treatment; however, after a mean time of 67.8 ± 34.6 months of follow-up, all patients in group LS had normal values of liver function and liver stiffness (5.3 ± 0.8 KPa) by ultrasound elastography (USE). Nonetheless, 5 patients (20%) after LS were still complicated with liver fibrosis, resulting in prolonged liver dysfunction for more than 2 years, which was consistent with the observations from some references [ 8 , 24 , 25 ].…”

Section: Discussionsupporting

confidence: 90%

The strategy of laparoscopic surgery for asymptomatic antenatally diagnosed choledochal cyst

et al. 2023

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Background The aim was to investigate the characteristics, surgical management, and outcomes of asymptomatic patients with antenatally diagnosed choledochal cysts (ADCCs) and to justify the strategy of laparoscopic surgery (LS) for them in our hospital. Methods We developed our LS strategy for asymptomatic ADCCs. Patients with asymptomatic ADCCs who underwent LS or open surgery (OS) during January 2010 and January 2020 were included. Patients with recorded symptomatic ADCCs were exclude. All data of group LS and group OS were statistically compared and analyzed. Results Twenty-five patients received LS and 18 patients received OS were included. There was no significant difference in baseline characteristics between the groups. A total of 65.1% of biliary sludge formation was detected preoperatively by ultrasonography (US) (72.0% in group LS, 55.6% in group OS, P = 0.26). Compared to the OS group, the LS group had a longer operative time (313.4 ± 27.2 vs. 154.0 ± 11.9 min, P = 0.02), shorter postoperative fasting period (3.1 ± 1.2 vs. 6.2 ± 2.3 days, P = 0.03), and shorter postoperative hospital stay (5.1 ± 1.9 vs. 9.2 ± 1.1 days, P = 0.03). The incidence of late complications, such as reflux cholangitis, adhesive intestinal obstruction, and biliary enteric anastomotic stricture with stone formation, was not significantly different between the two groups. The liver function and liver stiffness of all patients in the two groups were normal. Conclusions Based on the strategy for asymptomatic ADCCs in our hospital, the perioperative safety and midterm follow-up results after LS were satisfactory and comparable to those after OS.

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Section: Discussionsupporting

confidence: 90%

The strategy of laparoscopic surgery for asymptomatic antenatally diagnosed choledochal cyst

et al. 2023

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“…Complications such as recurrent cholangitis attacks, malignant transformation, intracystic or intrahepatic gallstone formation, cirrhosis development, and pancreatitis are common in patients who are not operated on. Complications such as anastomotic leakage, gastrointestinal or intraabdominal bleeding, acute pancreatitis, pancreatic leakage, wound infection, wound dehiscence, intraabdominal infection/abscess, intussusception can be seen in early postoperative period defined as short-term complications [150]. Most early complications can be treated conservatively [151].…”

Section: Outcomes and Resultsmentioning

confidence: 99%

Pediatric Choledochal Cysts: Unknowns are Decreasing

Gezer¹

2019

Pediatric Surgery, Flowcharts and Clinical Algorithms

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Choledochal cysts (CCs) are congenital cystic dilatation of extrahepatic and/ or intrahepatic bile ducts. CCs are more common in Asian population, the cause is still unknown. Although the etiology is controversial, the main elements in the natural historical emergence of the type I and type IV, which make up the majority of all types, have become clearer. The majority of CCs are diagnosed in childhood. Clinical presentation varies from jaundice in young patients to nonspecific abdominal pain in older, but morbidity increases with complications such as cholangitis, pancreatitis, perforation, hepatitis, liver failure, and malignancy in delayed diagnosed patients. MRCP is considered the current gold standard diagnostic modality that is able to accurately assess biliary anatomy. Although the treatment approach has been formed over the years, it still has not reached the last state. Eventually, the removal of the entire cyst and the reconstruction of the remaining biliary tract to drainage is the current treatment approach. But the dilemma is the way of reconstruction procedure (hepaticoduodenostomy or hepaticojejunostomy). All patients should be followed up for a long period of time, regardless of the surgery method.

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“…The risk of cancer increases with advanced age [8]. Biliary cysts can also have other complications such as cholelithiasis, cholangitis, jaundice, and pancreatitis [5,[7][8][9][10].…”

Section: Discussionmentioning

confidence: 99%

“…Some studies suggest that biliary tract malignancy occurs in more than 10% of patients in their third decade of life [4][5][6]. Cholangiocarcinoma is the most fatal complication of biliary cysts; however, various other complications were reported such as cholelithiasis, cholangitis, jaundice, and pancreatitis [7][8][9][10]. Identification of biliary cysts requires prompt surgical intervention to prevent such complications, which usually has a high success rate.…”

Section: Introductionmentioning

confidence: 99%

Biliary Cyst: An Unusual Cause of Cholestasis Post Cholecystectomy

Ayoub,

Faris,

Dodd

et al. 2024

Cureus

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Biliary cysts are relatively uncommon and they can be congenital or acquired and can have various presentations such as cholelithiasis, cholangitis, jaundice, and pancreatitis. Biliary cysts are associated with a high risk of biliary cancers and such risk increases with age. Identification of biliary cysts warrants an aggressive approach to lower cancer risk. Surgical management has a high success rate and it lowers morbidity, mortality, and cancer risk. We present a 40-year-old female who had a cholecystectomy in 2016. She presented with obstructive jaundice and was found to have a class I biliary cyst. She underwent endoscopic retrograde cholangiopancreatography with stenting which led to complete resolution of her symptoms. Later, she underwent elective Roux-en-Y hepaticojejunostomy with cyst resection three months later. She underwent a successful recovery.

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Clinical characteristics of liver fibrosis in patients with choledochal cysts

Cited by 19 publications

References 13 publications

The strategy of laparoscopic surgery for asymptomatic antenatally diagnosed choledochal cyst

The strategy of laparoscopic surgery for asymptomatic antenatally diagnosed choledochal cyst

Pediatric Choledochal Cysts: Unknowns are Decreasing

Biliary Cyst: An Unusual Cause of Cholestasis Post Cholecystectomy

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