Relationship between Anomalous Pancreaticobiliary Ductal Union and Pathologic Inflammation of Bile Duct in Choledochal Cyst

Park, Sowon; Koh, Hong; Oh, Jung Tak; Han, Seok Joo; Kim, Seung

doi:10.5223/pghn.2014.17.3.170

Cited by 28 publications

(14 citation statements)

References 26 publications

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“…The CDC occurs predominantly in females with a reported ratio of 3:1 to 4:1, although the reason for this gender predisposition is unclear. 1,14 In the present study, we observed a female: male ratio of about 3:1, which is consistent with findings in available literature.…”

Section: Discussionsupporting

confidence: 93%

“…[16][17][18][19][20][21][22][23] (Table 6), though larger series from other parts of World have shown a weaker link. [13][14][15] The incidence of APBDJ has been found to be low in major Indian series as well. 15,[24][25][26][27][28][29] In the present study, APBDJ was present 20% of patients, which is consistent with previous findings in Indian patients ( Table 7).…”

Section: Discussionmentioning

confidence: 99%

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A Single-Center Experience with 73 Patients of Adult Choledochal Cyst: An Indian Perspective

Kumar¹

2018

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Background: Aim of the study was to analyze the clinicopathological profile and long-term operative outcomes of patients with choledochal cysts (CDC) undergoing cyst excision. Methods: Clinical data of 73 adult CDC patients managed at a single tertiary care center between January 2010 and December 2016 were retrospectively analyzed. Patients who had undergone complete cyst excision and with a minimum follow-up of 12 months were included for long-term outcome analysis. Results: The male female ratio was approximately 1:3 and the median age was 35 years (range, 12-65 years). Type I CDC was the most common cyst type in this series (n=49/73, 67.1%). Abdominal pain was the commonest presenting symptom followed by jaundice, fever and palpable lump. Coexisting gallbladder carcinoma was encountered in 4/73 (5.48%) patients while two patients had secondary biliary cirrhosis with portal hypertension. Complete cyst excision was performed in 65 out of 73(89.0%) patients. Patients undergoing complete cyst excision were followed-up for a median duration of 29.5 months (range, 12-70 months). One case of hepaticojejunostomy stricture and two cases of post-operative incisional hernia were reported. No new case of cholangiocarcinoma was reported in any of our patients. Conclusion: Adulthood CDC are associated with an increased incidence of complications like recurrent cholangitis, pancreatitis and cyst perforation. The lesser association of biliary tract malignancy in Indian population may possibly be linked to a lower incidence of abnormal pancreaticobiliary duct junction. Complete cyst excision with hepaticojejunostomy remains the standard treatment both to relieve the symptoms and to minimize the risk of malignancy.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

A Single-Center Experience with 73 Patients of Adult Choledochal Cyst: An Indian Perspective

Kumar¹

2018

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“…Those of these malformations with cystic dilatation constitute the choledochal cyst. Although not proven, the commonly accepted theory [4][5] of their pathogenesis relies on the presence of an anomalous pancreaticobilliary junction (APBJ), which is seen in up to 90% patients with choledochal cyst. Lipsett [8,11] and Cho et al mentioned complete excision of extrahepatic component of choledochal cyst combined with cholecystectomy, followed by Roux-en-Y biliary reconstruction as the treatment of choice for type I and IV choledochal cyst.…”

Section: Discussionmentioning

confidence: 99%

“…Todani Type I cysts are the most common type and account for approximately 75% of patients. The most accepted theory in pathogenesis of choledochal cyst is Babbitt's theory' [3] is associated with anomalous pancreaticobiliary duct junction (APBDJ) [3][4]. Patients may present at any age with pain abdomen, jaundice and a right upper quadrant mass, however, 60 % of cases are diagnosed before the age of ten years [2].…”

Section: Introductionmentioning

confidence: 99%

Choledochal Cyst: A Retrospective Study Case Series

2017

IJSR

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Background and Objectives: Choledochal cyst is an uncommon congenital malformation of biliarysystem, involving cystic dilatation of intrahepatic and/or extra hepaticbile duct. The estimated incidence is one in 1000 live birth in Asian population [1-2] with female to male ratio is 3:1. The objective of this study is to study the presentation, diagnosis, treatment and outcomes of choledochal cyst in our tertiary care center. Materials and Methods: A retrospective review ofpatients, from Jan 2012 to April 2017, who were diagnosed as Choledochal cyst and treated by surgical intervention and their outcomes,in our tertiary care center. Results: We analyzed 16 cases of choledochal cyst. The condition commonly affected the pediatric age group (0 to 10 years)with female preponderance. Most common presenting symptom was pain in abdomen (75%) and jaundice (53%). However the classical triad of abdominal pain, jaundice, and an abdominal mass was not seen in any of the cases. Ultrasonography was diagnostic in all cases. Todani type I cyst was the most common type. Elevenout of 16 cases underwent complete cyst excision with cholecystectomy and Roux-en-Y hepaticojejunostomy without any major complication, however so many cases were not operated due to, not fit for surgery, not willing for surgery etc. Conclusion: Choledochal cyst is a clinical condition occurs, commonly in younger age group that is conveniently diagnosed on ultrasound and has a rewarding outcome if operated.

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“…Choledochal cyst is a cystic dilatation of the extra hepatic and/or intrahepatic bile duct 1 with an incidence of 1:1000 in Asian population. [2][3][4] It has female preponderance and female: male ratio is 3:1.…”

Section: Introductionmentioning

confidence: 99%

Choledochal Cyst: Their clinical presentation, diagnosis and treatment in central Nepal: a retrospective study

Kumar¹,

Jalan²,

Patowary³

2017

J Coll Med Sci-Nepal

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Background & Objectives:Choledochal cyst is a r ar e congenital malformation involving the cystic dilatation of intrahepatic and/ or extrahepatic bile duct .The estimated incidence is one in 1000 live birth in Asian population with female to male ratio 3:1. The objective of the study was to study the presentation, diagnosis, treatment and outcome of choledochal cyst in College of Medical Sciences, Bharatpur, Nepal Materials & Methods: A r etr ospective r eview of the r ecor ds of all the patients who were diagnosed as choledochal cyst and underwent medical or operative intervention in our hospital from January 2013-January 2015. Results: We analyzed ten cases of choledochal cyst. The condition commonly affected the age group of six to ten years with female preponderance (70%). Most common presenting symptom was pain abdomen (100%) and jaundice (50%). However classical triad of abdominal pain, jaundice, and an abdominal mass was not seen in any of the cases. Ultrasonography was diagnostic in all cases. Todani type I cyst was the most common type. Nine out of ten cases underwent complete cyst excision with cholecystectomy and Roux-en-Y hepaticojejunostomy without any major complication. Conclusion: Choledochal cyst is a clinical condition that is conveniently diagnosed on ultrasound and has a rewarding outcome if operated

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Relationship between Anomalous Pancreaticobiliary Ductal Union and Pathologic Inflammation of Bile Duct in Choledochal Cyst

Cited by 28 publications

References 26 publications

A Single-Center Experience with 73 Patients of Adult Choledochal Cyst: An Indian Perspective

A Single-Center Experience with 73 Patients of Adult Choledochal Cyst: An Indian Perspective

Choledochal Cyst: A Retrospective Study Case Series

Choledochal Cyst: Their clinical presentation, diagnosis and treatment in central Nepal: a retrospective study

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