Development of intrahepatic biliary stones after excision of choledochal cysts

Tsuchida, Yoshiaki; Takahashi, Atsushi; Suzuki, Norio; Kuroiwa, Minoru; Murai, Hideaki; Toki, Fumiaki; Kawarasaki, Hideo; Hashizume, Kohei; Honna, Toshiro

doi:10.1053/jpsu.2002.30243

Cited by 42 publications

(23 citation statements)

References 10 publications

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“…However, though most patients remained well, regular follow-up is mandatory as some did develop complications subsequently such as stricture, cholangitis, stump pancreatitis and even adhesive intestinal obstruction. This concurs with the observation reported in the literature [2,[24][25][26]. In addition, on careful follow-up, some did have certain degree of fat intolerance and required diet adjustment.…”

Section: Discussionsupporting

confidence: 91%

Laparoscopic excision of choledochal cysts in children: an intermediate-term report

Lee

Tam

Yeung³

et al. 2009

Pediatr Surg Int

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Section: Discussionsupporting

confidence: 91%

Laparoscopic excision of choledochal cysts in children: an intermediate-term report

Lee

Tam

Yeung³

et al. 2009

Pediatr Surg Int

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“…These complications are likely to develop secondary to a postoperative anastomotic stricture in the intrahepatic duct dilatation, and they occur more commonly in patients with type IVa than in patients with type I choledochal cyst. [10][11][12][13] Therefore, a question arises why postoperative anastomotic stricture is more common in the type IVa than type I choledochal cyst. The aim of this study was to investigate clinical features of the anastomotic stricture and to elucidate the clinicopathological factors associated with anastomotic stricture after excision of choledochal cysts.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors of Postoperative Anastomotic Stricture After Excision of Choledochal Cysts with Hepaticojejunostomy

Kim

Choi

Han

et al. 2008

Journal of Gastrointestinal Surgery

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The aim of this study was to investigate the risk factors of postoperative anastomotic stricture after excision of choledochal cysts and hepaticojejunostomy. Among 65 patients who underwent surgery for choledochal cyst between March 1995 and June 2005, we selected 34 adult patients who were diagnosed as having choledochal cyst. We divided patients into two groups, depending on postoperative anastomotic stricture developed or not. Medical records and radiological findings of each patient were reviewed retrospectively. H&E stain and Masson-Trichrome stain of each specimen of the resected cyst were performed, and thickness of cyst wall, the grade of fibrosis, loss of smooth muscle layer, loss of mucosa, and infiltration of inflammatory cells were measured. Of the 34 patients, excision of choledochal cyst and hepaticojejunostomy were done in 33 patients, and 1 patient with chronic pancreatitis underwent pylorus-preserving pancreaticoduodenectomy. Anastomotic stricture and intrahepatic duct stones postoperatively developed in eight patients; one patient of 19 type I cyst and seven patients of 15 type IVa, developing significantly more in the type IVa choledochal cyst (P<0.05). The size of choledochal cyst in the stricture group was 7.0 cm, and that of the non-stricture group, 4.2 cm, showing significant difference between the two groups (P<0.05). The stricture group presented shorter duration of symptoms (27.63±61.72 days; ranged, 1∼180 days) than the non-stricture group (483.33±916.41 days; ranged, 1∼3,560 days), and it was statistically significant (P<0.05). Pathologically, significant difference was found between anastomotic stricture and infiltration of inflammatory cells (P<0.05). The results indicate that anastomotic stricture is influenced by the type IVa choledochal cyst, size of cyst, duration of symptoms, and the grade of infiltration of inflammatory cells. Therefore, closed careful follow-up is important in patients who underwent cyst excision with hepaticojejunostomy for type IVa choledochal cyst. If the anastomotic stricture develops, nonoperative management should be recommended, rather than operation, as much as possible.

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“…The development of intra-and extrahepatic bile duct stones has been reported as one of the most serious complications following choledochal cyst excision (3,4,(6)(7)(8). ESWL, which is performed without laparotomy or puncture, is a less invasive, novel technique, which uses shock waves to fragment calculi.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of extracorporeal shock wave lithotripsy on intrahepatic biliary calculi developing after choledochal cyst surgery: A case report

Şenyüz

Gülşen²,

Okan³

et al. 2015

Turk J Gastroenterol

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Development of intrahepatic biliary stones after excision of choledochal cysts

Cited by 42 publications

References 10 publications

Laparoscopic excision of choledochal cysts in children: an intermediate-term report

Laparoscopic excision of choledochal cysts in children: an intermediate-term report

Risk Factors of Postoperative Anastomotic Stricture After Excision of Choledochal Cysts with Hepaticojejunostomy

Effectiveness of extracorporeal shock wave lithotripsy on intrahepatic biliary calculi developing after choledochal cyst surgery: A case report

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