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Talini C, DE-Carvalho BCN, Antunes LA, Schulz C, Sabbaga CC, Avilla SGA, Garbers JC, DE-Aguiar LRF, Telles LG, DE-Almeida GC, Amado FAB, E-Silva EDEM. Choledochal cyst in the pediatric population: experience of 13 laparoscopic procedures in two years at a single institution. ACTA ACUST UNITED AC 2018; 45:e1854. [PMID: 29995153 DOI: 10.1590/0100-6991e-20181854] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 03/22/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVE to describe the first 13 cases of laparoscopic correction of common bile duct cyst in the Pequeno Príncipe Hospital, Curitiba, Paraná, Brazil. METHODS we performed a retrospective analysis of medical records of cases of choledochal cyst operated by laparoscopy between March 2014 and September 2016. RESULTS of the 13 patients, eight were female and the mean age at surgery was 7.8 years. The most common symptom was abdominal pain. The hepaticoduodenal anastomosis was the most used reconstruction technique, in 84.6% of the cases. There was no conversion to laparotomy or intraoperative complications. Only one patient presented anastomotic fistula and was reoperated by laparotomy. All patients were followed up in an outpatient clinic, were asymptomatic and had no episode of cholangitis after surgery, with a mean follow-up of 16 months. CONCLUSION laparoscopy is a safe method to correct choledochal cysts, even in younger children, with low rates of complications and low rates of conversion to open surgery when performed by well trained surgeons.
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Affiliation(s)
- Carolina Talini
- - Pequeno Príncipe Hospital, Department of Pediatric Surgery, Curitiba, PR, Brazil
| | | | | | - Claudio Schulz
- - Pequeno Príncipe Hospital, Department of Pediatric Surgery, Curitiba, PR, Brazil
| | | | | | - João Carlos Garbers
- - Pequeno Príncipe Hospital, Department of Pediatric Surgery, Curitiba, PR, Brazil
| | | | - Leila Grisa Telles
- - Pequeno Príncipe Hospital, Department of Pediatric Surgery, Curitiba, PR, Brazil
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González Ruiz Y, Bragagnini Rodriguez P, Fernández Atuán RL, Álvarez García N, Siles Hinojosa A, González Martínez-Pardo N, Elías Pollina J. Prenatal diagnosis of a giant choledochal cyst. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2016. [DOI: 10.1016/j.epsc.2015.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Jensen KK, Sohaey R. Antenatal sonographic diagnosis of choledochal cyst: Case report and imaging review. JOURNAL OF CLINICAL ULTRASOUND : JCU 2015; 43:581-583. [PMID: 25502408 DOI: 10.1002/jcu.22256] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 11/16/2014] [Indexed: 06/04/2023]
Abstract
In this report, we present the antenatal two- and three-dimensional sonographic findings from a fetus with choledochal cyst as well as confirmatory postnatal MRI. A delayed diagnosis of choledochal cyst is common, leading to significant morbidity and mortality. Visualizing bile ducts entering a right upper quadrant cyst is pathognomonic, and early diagnosis can facilitate definitive treatment with Roux-en-Y hepaticojejunostomy.
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Affiliation(s)
- Kyle K Jensen
- Oregon Health & Science University, Department of Diagnostic Radiology, Portland, OR
| | - Roya Sohaey
- Oregon Health & Science University, Department of Diagnostic Radiology, Portland, OR
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Cong X, Sun X, Liu S. Evaluation and screening ultrasonic signs in the diagnosis of fetal biliary cystic malformation. J Matern Fetal Neonatal Med 2014; 28:2100-5. [PMID: 25330845 DOI: 10.3109/14767058.2014.979148] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Xiang Cong
- Department of Ultrasound, Qilu Hospital of Shandong University, Jinan, P.R. China and
| | - Xiubin Sun
- Department of Statistics, Public Health School of Shandong University, Jinan, P.R. China
| | - Shaoping Liu
- Department of Ultrasound, Qilu Hospital of Shandong University, Jinan, P.R. China and
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Mashima M, Tanaka H, Numoto A, Kubo H, Shimono R, Kusaka T, Itoh S, Hata T. Antenatal three-dimensional sonographic features of fetal biliary atresia. J Med Ultrason (2001) 2013; 40:279-81. [PMID: 27277250 DOI: 10.1007/s10396-012-0425-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Accepted: 11/26/2012] [Indexed: 11/26/2022]
Abstract
We present antenatal three-dimensional (3D) sonographic features of fetal biliary atresia. A 38-year-old pregnant Japanese woman was referred to our ultrasound clinic because of a fetal intra-abdominal cyst at 19 weeks of gestation. Conventional two-dimensional (2D) sonography and 3D sonography with an inversion mode showed a round cyst with a tiny dip in the subhepatic area. At 34 weeks, conventional 2D sonography and 3D sonography with inversion and transparent X-ray modes clearly revealed a round to oval cyst connected with the gallbladder via the cystic duct. A diagnosis of choledochal cyst (type I) was suggested antenatally. However, the final diagnosis made by employing operative cholangiography during surgery was biliary atresia (type I cyst) at 25 days of life. To the best of our knowledge, this is the first report of biliary atresia employing antenatal 3D sonography with inversion and transparent X-ray modes.
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Affiliation(s)
- Masato Mashima
- Department of Perinatology and Gynecology, Kagawa University School of Medicine, 1750-1 Ikenobe, Miki, Kagawa, 761-0793, Japan
| | - Hirokazu Tanaka
- Department of Perinatology and Gynecology, Kagawa University School of Medicine, 1750-1 Ikenobe, Miki, Kagawa, 761-0793, Japan
| | - Atsuo Numoto
- Department of Obstetrics and Gynecology, Numoto Ladies Clinic, 4-8 Higashitamachi, Takamatsu, Kagawa, 760-0058, Japan
| | - Hiroyuki Kubo
- Department of Pediatric Surgery, Kagawa University School of Medicine, 1750-1 Ikenobe, Miki, Kagawa, 761-0793, Japan
| | - Ryuichi Shimono
- Department of Pediatric Surgery, Kagawa University School of Medicine, 1750-1 Ikenobe, Miki, Kagawa, 761-0793, Japan
| | - Takashi Kusaka
- Department of Pediatrics, Kagawa University School of Medicine, 1750-1 Ikenobe, Miki, Kagawa, 761-0793, Japan
| | - Susumu Itoh
- Department of Pediatrics, Kagawa University School of Medicine, 1750-1 Ikenobe, Miki, Kagawa, 761-0793, Japan
| | - Toshiyuki Hata
- Department of Perinatology and Gynecology, Kagawa University School of Medicine, 1750-1 Ikenobe, Miki, Kagawa, 761-0793, Japan.
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Jabłońska B. Biliary cysts: Etiology, diagnosis and management. World J Gastroenterol 2012; 18:4801-10. [PMID: 23002354 PMCID: PMC3447264 DOI: 10.3748/wjg.v18.i35.4801] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2012] [Revised: 06/05/2012] [Accepted: 07/09/2012] [Indexed: 02/06/2023] Open
Abstract
Biliary cysts (BC) are rare dilatations of different parts of a biliary tract. They account for approximately 1% of all benign biliary diseases. BC occur the most frequently in Asian and female populations. They are an important problem for pediatricians, gastroenterologists, radiologists and surgeons. Clinical presentation and management depend on the BC type. Cholangiocarcinoma is the most serious and dangerous BC complication. The other complications associated with BC involve cholelithiasis and hepatolithiasis, cholangitis, acute and chronic pancreatitis, portal hypertension, liver fibrosis and secondary liver cirrhosis and spontaneous cyst perforation. Different BC classifications have been described in the literature. Todani classification dividing BC into five types is the most useful in clinical practice. The early diagnosis and proper treatment are very important, because BC are associated with a risk of carcinogenesis. A malignancy risk increases with the age. Radiological investigations (ultrasonography, computed tomography, endoscopic retrograde cholangiopancreatography and magnetic resonance cholangiopancreatography) play an important role in BC diagnostics. Currently, prenatal diagnosis using ultrasonography is possible. It allows to differentiate biliary disorders in fetals and to perform the early surgical treatment that improves results. In most patients, total cyst excision with Roux-Y hepaticojejunostomy is the treatment of choice. Surgical treatment of BC is associated with high success rate and low morbidity and mortality. The early treatment is associated with a lower number of complications. Patients following BC surgery require permanent and careful postoperative observation using laboratory and imaging investigations because of possibility of biliary anastomosis stricture and biliary cancer in tissue remnant.
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