Long-term outcomes after hepaticojejunostomy for choledochal cyst: a 10- to 27-year follow-up

Ono, Shigeru; Fumino, Shigehisa; Shimadera, Shinichi; Iwai, Naoharu

doi:10.1016/j.jpedsurg.2009.10.078

Cited by 93 publications

(74 citation statements)

References 13 publications

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“…What has been less clear is whether such dilatation persists after definitive surgery and its contribution to the long-term outcome of these patients. Certainly, complications such as stone formation and carcinomatous change seem to occur in those patients left with dilated intrahepatic biliary tracts [8][9][10][11][12].…”

mentioning

confidence: 99%

Intrahepatic duct dilatation in type 4 choledochal malformation: pressure-related, postoperative resolution

Hill

Parsons

Farrant

et al. 2011

Journal of Pediatric Surgery

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mentioning

confidence: 99%

Intrahepatic duct dilatation in type 4 choledochal malformation: pressure-related, postoperative resolution

Hill

Parsons

Farrant

et al. 2011

Journal of Pediatric Surgery

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“…Biliary tract obstruction may occur after laparoscopic hepaticojejunostomy. 11 Ono et al 3 reported liver dysfunction, dilatation of intrahepatic bile ducts, recurrent abdominal pain, and biliary tract malignancy as longterm complications after choledochal cyst excision and hepaticojejunostomy. The laparoscopic approach can magnify the operative view, which may assist in dissecting the whole choledochal cyst without a remnant duct, and in anastomosis.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, choledochal cysts can transform into biliary malignancies if not treated. 2,3 Hence, complete surgical excision of the choledochal cyst and enterobiliary reconstruction has been recommended as the standard treatment.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Choledochal Cyst Excision and Hepaticojejunostomy: A Case Series

Koo

Jung

Choi

2017

J Minim Invasive Surg

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Purpose: Choledochal cysts are congenital dilatations of the biliary tract and are generally surgically excised. Laparoscopic total excision of choledochal cysts and hepaticojejunal biliary tract reconstruction has gained acceptance among pediatric surgeons. We report our early experience with this procedure. Methods:From May 2013 to April 2016, 10 consecutive patients (7 females and 3 males) underwent laparoscopic choledochal cyst excision and hepaticojejunostomy at our center. We retrospectively reviewed their medical records for age, sex, clinical symptoms, Todani classification, anomalous pancreaticobiliary duct union, operative time, starting day for enteral feeding, complications, and hospital stay. Results:The median patient age was 22 months. Four patients were aged less than 6months, 3 of whom received prenatal diagnosis using ultrasonography. Patients presented with abdominal pain, jaundice, vomiting and fever. No abdominal mass was palpated in any patient. One patient was classified as Todani type Ia, 4 as Ic, and 5as IVa. Six patients had an anomalous pancreaticobiliary duct union. The mean operative time was 319.4 minutes. There were no surgery-related complications. Sips of water were allowed from mean postoperative day 2.4 and regular diet from mean postoperative day 3.4. The mean hospital stay was 6.5 days. Conclusion:Laparoscopic excision of choledochal cyst and hepaticojejunostomy in children is feasible with favorable cosmesis.

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“…44 Because of the high frequency of biliary tract malignancy in patients with PBM, we have recommended total resection of the extrahepatic bile duct for patients with PBM, even for children and those with the nondilatation ///type of PBM. 6 Surgical intervention is essential for the treatment of PBM.…”

Section: Treatment Of Children With Pbmmentioning

confidence: 99%

“…45,46 Therefore, successive follow-up is needed for patients who undergo total resection of a choledochal cyst with PBM, especially for patients with some complications, such as biliary stones or stenosis of the intrahepatic bile duct. 44 From the point of view of convenience and reliability, a combination of ultrasonography and CT scans once per year on an outpatient basis is therefore considered to be suitable for successive follow-up in children with PBM after surgery.…”

Section: Treatment Of Children With Pbmmentioning

confidence: 99%

Diagnosis and treatment of pancreaticobiliary maljunction in children

2011

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Pancreaticobiliary maljunction (PBM), which may be called by synonymous terms such as "anomalous arrangement of the pancreaticobiliary duct" or "anomalous union of biliopancreatic ducts," is defined as an anatomical maljunction of the pancreatic duct and the biliary duct outside of the duodenal wall beyond the influence of the sphincter of Oddi. Pancreaticobiliary maljunction is classified into three groups according to the type of the pancreaticobiliary junction. Pancreaticobiliary maljunction is diagnosed mainly by endoscopic retrograde cholangiopancreatography; however, in pediatric patients, it may be diagnosed by intraoperative cholangiography, and more recently has been diagnosed by computed tomographic cholangiography or contrast-enhanced helical computed tomography. Children with PBM without choledochal cysts usually do not show any symptoms except for abdominal pain and hyperamylasemia. Pancreaticobiliary maljunction is considered to be a major risk factor for biliary tract malignancy. In patients with PBM, free reflux of pancreatic juice into the biliary tract might induce biliary tract damage and biliary carcinogenesis. Thus, total resection of the extrahepatic bile duct and hepaticojejunostomy are recommended in children diagnosed with PBM with choledochal cyst. Early diagnosis and early surgical treatment provide a good prognosis with few complications. In addition, successive follow-up is necessary for early detection of biliary tract malignancy, especially in patients demonstrating postoperative complications.

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Long-term outcomes after hepaticojejunostomy for choledochal cyst: a 10- to 27-year follow-up

Cited by 93 publications

References 13 publications

Intrahepatic duct dilatation in type 4 choledochal malformation: pressure-related, postoperative resolution

Intrahepatic duct dilatation in type 4 choledochal malformation: pressure-related, postoperative resolution

Laparoscopic Choledochal Cyst Excision and Hepaticojejunostomy: A Case Series

Diagnosis and treatment of pancreaticobiliary maljunction in children

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