1
|
Li B, Chen BW, Xia LS. The Initial Experience of Laparoscopic Management for Type VI Choledochal Cyst in Children. J Laparoendosc Adv Surg Tech A 2024; 34:280-283. [PMID: 37844069 DOI: 10.1089/lap.2023.0229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023] Open
Abstract
Purposes: Dilatation of cystic duct is very rare and had been classified as Todani type VI choledochal cyst. Choledochal cyst combined with dilatation of cystic duct is difficult to diagnose preoperatively. The purpose of this study is to report the rare variants and discuss the significance and laparoscopic management strategy in children. Methods: The subjects for this study were 10 consecutive patients with type VI choledochal cyst who had laparoscopic procedures at our institute between January 2009 and January 2023. Laparoscopic cholecystectomy, excision of the dilated cystic duct, and choledochal cyst were carried out, and the continuity of the biliary duct was re-established through a Roux-en-Y hepaticojejunostomy. Results: Cystic duct combined with the common bile duct dilatation was revealed in all the patients intraoperatively. Laparoscopic procedures were completed with no conversions. The postoperative recovery was uneventful. The mean follow-up duration was 27 ± 12.7 months (range 5-36 months) with no postoperative complications encountered. Conclusions: The rare entity of type VI choledochal cyst should be recognized as a distinct type of choledochal cyst and need to be given enough attention clinically. The laparoscopic procedure is a feasible option for experienced surgeons.
Collapse
Affiliation(s)
- Bing Li
- Department of Pediatric Surgery, Huai'an Women and Children's Hospital, Huai'an, P.R. China
| | - Bing Wei Chen
- Department of Pediatric Surgery, Huai'an Women and Children's Hospital, Huai'an, P.R. China
| | - Lin Shun Xia
- Department of Pediatric Surgery, Huai'an Women and Children's Hospital, Huai'an, P.R. China
| |
Collapse
|
2
|
Durgun AV, Ergün S, Turgut BC, Şimşek O, Velidedeoglu M, Sarıbeyoğlu K, Pekmezci S. Biliary cysts in adults: Cerrahpaşa experience. Turk J Surg 2023; 39:315-320. [PMID: 38694518 PMCID: PMC11057935 DOI: 10.47717/turkjsurg.2023.6285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 12/16/2023] [Indexed: 05/04/2024]
Abstract
Objectives Biliary cysts are biliary duct dilatations, with 20% of the cysts being diagnosed in adulthood. Abdominal pain, jaundice and palpable abdominal mass are defined as the classical triad. However, nausea, vomiting, fever, itching and weight loss are frequent complaints. There are several treatment options depending on the type of the cyst. This study aimed to share our experience with biliary cysts and contribute to the literature on this subject. Material and Methods Thirty patients, who received treatment for biliary cyst from January 1981 to December 2018 at our clinic, were studied retrospectively. The patients were analyzed based on age, sex, type of the cyst, diagnosis and treatment methods, post-op follow up and complications. Results Twenty-seven of the patients were females, and three were males. The patients were aged between 16 and 76 years, and the median age was 41.9 years. All patients presented with abdominal pain, which was accompanied by cholangitis in nine patients, nausea and vomiting in four patients, dyspepsia in three patients and palpable mass in one patient. According to the Todani classification, biliary cyst findings were consistent with Type I in 23 patients, Type V in three patients, Type IV in two patients, Type II in one patient and Type III in one patient. Conclusion Diagnosis and treatment are complex in biliary cysts due to anatomical proximity and variations. Therefore, it would be beneficial to refer them to referral centers. Choice of treatment should be based on the type of the cyst.
Collapse
Affiliation(s)
- Ali Vedat Durgun
- Department of General Surgery, İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, İstanbul, Türkiye
| | - Sefa Ergün
- Department of General Surgery, İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, İstanbul, Türkiye
| | - Başar Can Turgut
- Department of General Surgery, İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, İstanbul, Türkiye
| | - Osman Şimşek
- Department of General Surgery, İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, İstanbul, Türkiye
| | - Mehmet Velidedeoglu
- Department of General Surgery, İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, İstanbul, Türkiye
| | - Kaya Sarıbeyoğlu
- Department of General Surgery, Charite University, Berlin, Germany
| | - Salih Pekmezci
- Department of General Surgery, İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, İstanbul, Türkiye
| |
Collapse
|
3
|
Type II choledochal cyst of the cystic duct in a 3 Month old. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2022. [DOI: 10.1016/j.epsc.2022.102440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
|
4
|
Cystic duct cyst in adults: a systematic review of the sixth entity. Surg Today 2022; 53:527-543. [PMID: 35124738 DOI: 10.1007/s00595-022-02461-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 12/09/2021] [Indexed: 10/19/2022]
Abstract
Over the past two decades, there have been an increasing number of reports describing a sixth type of choledochal cyst (cystic duct cyst) in adults that was not included in Todani's classification. This sixth entity has not yet been systematically reviewed in the literature. We therefore explored this condition in adults from the perspective of the clinical presentation, diagnosis and treatment through a systematic review of the evidence. The final analysis included 33 reported cases, with 55% of them reported in Asia. The mean age was 39.3 years old, with a female-to-male ratio of 1.5:1. Magnetic resonance cholangiopancreatography was accurate in establishing the diagnosis in 69% of cases. Where reported, standard laparoscopic/open cholecystectomy was performed in about 74% of patients, while around 25% of them needed extensive surgery. Associated malignancy was reported in 6.1% of cases, while 28% of patients had co-existent gallstone-related disease. No significant post-operative morbidity or mortality was reported. In this era of emergency laparoscopic cholecystectomy, surgeons should be aware of this rare condition, with the particular understanding that it is associated with gallstone-related disease in a significant number of reported cases.
Collapse
|
5
|
Harikrishnan S, Chandramohan SM, Chandramohan A. Giant choledochal cyst type 4A: a surgical challenge. Pan Afr Med J 2020; 37:95. [PMID: 33425128 PMCID: PMC7757274 DOI: 10.11604/pamj.2020.37.95.24811] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 07/19/2020] [Indexed: 11/22/2022] Open
Abstract
Choledochal cysts are rare congenital anomalies of the biliary tract. There are 5 subtypes of choledochal cyst and in adults type 4 is the most common. Choledochal cyst rarely exceeds the size of 6cm in the reported literature. Only a handful of cases of giant choledochal cysts are reported in the literature. Here we report a case of a 33-year-old lady who presented with a huge abdominal mass and on evaluation was found to have a giant choledochal cyst type 4A. The patient underwent excision of the extrahepatic hugely dilated choledochal cyst with cholecystectomy and reconstruction was done by Roux-en-Y hepaticojejunostomy to the confluence of the right and left hepatic duct at the hilum.
Collapse
|
6
|
Quang KT, Hunter JL, Wilson JW, Simmons JD. Choledochal Cyst Originating From the Cystic Duct. Am Surg 2020; 87:154-155. [PMID: 32870020 DOI: 10.1177/0003134820945235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Kenny T Quang
- Department of Surgery, Division of Acute Care Surgery and Burns, University of South Alabama, Mobile, AL, USA
| | - Justin L Hunter
- Department of Surgery, Division of Acute Care Surgery and Burns, University of South Alabama, Mobile, AL, USA
| | - John W Wilson
- Department of Surgery, Division of Acute Care Surgery and Burns, University of South Alabama, Mobile, AL, USA
| | - Jon D Simmons
- Department of Surgery, Division of Acute Care Surgery and Burns, University of South Alabama, Mobile, AL, USA
| |
Collapse
|
7
|
Ackermann T, Spilias D. Type VI choledochal cyst: a rare entity. ANZ J Surg 2020; 90:E215-E216. [PMID: 32441871 DOI: 10.1111/ans.16011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 05/03/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Travis Ackermann
- Upper Gastrointestinal and Hepatobiliary Surgery, Monash Health, Melbourne, Victoria, Australia
| | - Dean Spilias
- Upper Gastrointestinal and Hepatobiliary Surgery, Monash Health, Melbourne, Victoria, Australia.,Department of Surgery, Monash University, Melbourne, Victoria, Australia
| |
Collapse
|
8
|
Ku L, Paez MA, O'Leary MP, Hari DM, Reicher S. Type VI choledochal cyst diagnosed on ERCP with direct cholangioscopy. VIDEOGIE : AN OFFICIAL VIDEO JOURNAL OF THE AMERICAN SOCIETY FOR GASTROINTESTINAL ENDOSCOPY 2019; 4:458-460. [PMID: 31709329 PMCID: PMC6831943 DOI: 10.1016/j.vgie.2019.07.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Lawrence Ku
- Division of Gastroenterology, Harbor-UCLA Medical Center, Torrance, California, USA
| | - Marco A Paez
- Division of Gastroenterology, Harbor-UCLA Medical Center, Torrance, California, USA
| | - Michael P O'Leary
- Department of Surgery, Division of Surgical Oncology, Harbor-UCLA Medical Center, Torrance, California, USA
| | - Danielle M Hari
- Department of Surgery, Division of Surgical Oncology, Harbor-UCLA Medical Center, Torrance, California, USA
| | - Sofiya Reicher
- Division of Gastroenterology, Harbor-UCLA Medical Center, Torrance, California, USA
| |
Collapse
|
9
|
Amarjothi JMV, Ramasamy V, Jesudasan J, NaganathBabu OL. Type VI Choledochal Cysts-Case Report and Review of Literature. Surg J (N Y) 2019; 5:e82-e86. [PMID: 31453343 PMCID: PMC6707803 DOI: 10.1055/s-0039-1693652] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Accepted: 06/12/2019] [Indexed: 02/07/2023] Open
Abstract
Choledochal cysts (CDC), are rare congenital dilations involving the extra hepatic biliary apparatus with or without dilation of the intrahepatic bile ducts. They are conventionally classified into five types. A new type, type VI, causing dilation of the cystic duct between the neck of the gall bladder and the common hepatic duct (CHD) has been described in medical literature which is the rarest of all these subtypes. They are commonly observed in middle aged females and are mostly symptomatic. Most of these cysts need magnetic resonance cholangiopancreatography (MRCP) for accurate diagnosis. Treatment options for these lesions are not well defined but range from simple cholecystectomy to complete excision of the entire bile duct and biliary reconstruction, as there is a concern of malignant transformation in these cysts. Hence, these rare cysts, though rare, must be borne in mind when dealing with suspicious cystic lesions in the biliary tract. Here, we present an interesting case of such a rare cyst and its management in a middle aged woman.
Collapse
Affiliation(s)
- J. M. V. Amarjothi
- Department of Surgical Gastroenterology, Madras Medical College, Rajiv Gandhi Government General Hospital, Chennai, Tamilnadu, India
| | - Villalan Ramasamy
- Department of Surgical Gastroenterology, Madras Medical College, Rajiv Gandhi Government General Hospital, Chennai, Tamilnadu, India
| | - Jeyasudhahar Jesudasan
- Department of Surgical Gastroenterology, Madras Medical College, Rajiv Gandhi Government General Hospital, Chennai, Tamilnadu, India
| | - O. L. NaganathBabu
- Department of Surgical Gastroenterology, Madras Medical College, Rajiv Gandhi Government General Hospital, Chennai, Tamilnadu, India
| |
Collapse
|
10
|
Perfecto Valero A, Gastaca Mateo M, Prieto Calvo M, Ortiz de Urbina López J, Valdivieso López A. Quiste biliar del conducto cístico. Un caso de Todani tipo VI. Cir Esp 2018; 96:659-661. [DOI: 10.1016/j.ciresp.2018.04.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 04/04/2018] [Accepted: 04/24/2018] [Indexed: 10/28/2022]
|
11
|
Affiliation(s)
- Amber Quintana
- Department of Surgery Meharry Medical College Nashville, Tennessee
| | | |
Collapse
|
12
|
Kilambi R, Singh AN, Madhusudhan KS, Das P, Pal S. Choledochal cyst of the proximal cystic duct: a taxonomical and therapeutic conundrum. Ann R Coll Surg Engl 2017; 100:e34-e37. [PMID: 29181996 DOI: 10.1308/rcsann.2017.0201] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Isolated choledochal cysts involving the cystic duct are rare. We present a case of a choledochal cyst involving only the proximal cystic duct, and discuss the taxonomic and therapeutic challenges. There is a need for a clearly defined classification system for these cysts as they may be categorised as either type II or type VI cysts. The optimal treatment remains debatable, with some authors recommending a bilioenteric reconstruction owing to the wide cystic duct-bile duct junction. However, we suggest that a cholecystectomy should be performed with examination of the specimen and frozen section in case of any abnormality rather than upfront bile duct excision. In addition, given the rarity of this condition and the paucity of long-term data, we recommend meticulous follow-up for development of any malignancy.
Collapse
Affiliation(s)
- R Kilambi
- All India Institute of Medical Sciences , New Delhi , India
| | - A N Singh
- All India Institute of Medical Sciences , New Delhi , India
| | | | - P Das
- All India Institute of Medical Sciences , New Delhi , India
| | - S Pal
- All India Institute of Medical Sciences , New Delhi , India
| |
Collapse
|
13
|
Tsai CC, Huang PK, Liu HK, Su YT, Yang MC, Yeh ML. Pediatric types I and VI choledochal cysts complicated with acute pancreatitis and spontaneous perforation: A case report and literature review. Medicine (Baltimore) 2017; 96:e8306. [PMID: 29049233 PMCID: PMC5662399 DOI: 10.1097/md.0000000000008306] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Choledochal cysts are a congenital disorder of the common bile duct that can cause progressive biliary obstruction and biliary cirrhosis. They were classified by Todani into five types. Of these, type VI choledochal cysts are rarely reported in the literature. PATIENT CONCERNS A 22-month-old girl presented with intermittent epigastralgia for approximately 10 days and fever for three days. Fasting and total parenteral nutrition were administered after admission. However, sudden onset of severe epigastric pain occurred. An abdominal sonogram showed turbid ascites and peritonitis was impressed. DIAGNOSES An emergent exploratory laparotomy was performed, and perforation of the posterior wall of types I and VI choledochal cysts was observed. INTERVENTIONS Intraoperative cholangiography revealed concomitant types I and VI choledochal cysts with stricture of the distal common bile duct. Definite surgery for resection of the choledochal cysts and gallbladder was performed with Roux-en-Y choledochojejunostomy. OUTCOMES The patient had no evidence of ascending cholangitis at three years after the operation. LESSONS Type VI choledochal cysts are rarely reported in the literature. To our knowledge, this is the first reported pediatric case of concomitant types I and VI choledochal cysts complicated with acute pancreatitis and spontaneous perforation.
Collapse
Affiliation(s)
| | | | | | | | | | - Ming-Lun Yeh
- Department of Pediatric Surgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan (R.O.C.)
| |
Collapse
|
14
|
Youn JK, Kim H, Kim HY, Jung SE. Isolated cystic duct cyst with associated stones in a 4-month-old boy. Ann Surg Treat Res 2016; 90:350-2. [PMID: 27274512 PMCID: PMC4891527 DOI: 10.4174/astr.2016.90.6.350] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 02/22/2016] [Accepted: 03/28/2016] [Indexed: 11/30/2022] Open
Abstract
Isolated cystic duct cysts are rare entities, with few cases having been reported. We present the case of a 4-month-old male patient presenting with abdominal pain and vomiting. Ultrasonography and magnetic resonance cholangiopancreatography revealed an isolated cystic duct cyst with associated stones. The patient underwent open cholecystectomy with complete cyst excision and cystic duct transection; there were no postoperative complications. While lesions like the one described herein are extremely rare, they should be included as a separate category in classifications of choledochal cysts.
Collapse
Affiliation(s)
- Joong Kee Youn
- Department of Pediatric Surgery, Seoul National University Children's Hospital, Seoul, Korea
| | - Hyejin Kim
- Department of Pediatric Surgery, Seoul National University Children's Hospital, Seoul, Korea
| | - Hyun-Young Kim
- Department of Pediatric Surgery, Seoul National University Children's Hospital, Seoul, Korea
| | - Sung-Eun Jung
- Department of Pediatric Surgery, Seoul National University Children's Hospital, Seoul, Korea
| |
Collapse
|
15
|
Sethi S, Upreti L, Verma AK, Puri SK. Choledochal cyst of the cystic duct: Report of imaging findings in three cases and review of literature. Indian J Radiol Imaging 2015; 25:315-20. [PMID: 26288528 PMCID: PMC4531458 DOI: 10.4103/0971-3026.161468] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The choledochal cysts, which refer to the cystic dilatation of the biliary duct, are rare lesions generally seen in children. Choledochal cyst of the cystic duct is an uncommon entity. Often, it is associated with the choledochal cyst of the rest of the biliary tree. Isolated cystic duct choledochal cyst is quite rare. Most of these lesions have been recognized only on surgery. Modern cross-sectional imaging methods have facilitated preoperative recognition and characterization of cystic duct cyst enabling formulation of appropriate management strategy. We report the imaging findings in three cases of choledochal cyst involving the cystic duct. All these cases were correctly diagnosed preoperatively. A review of cases reported in the literature and the role of imaging in guiding the management are also presented.
Collapse
Affiliation(s)
- Sonali Sethi
- Department of Radiology, Govind Ballabh Pant Hospital, New Delhi, India
| | - Lalendra Upreti
- Department of Radiology, Govind Ballabh Pant Hospital, New Delhi, India
| | - Amit K Verma
- Department of Radiology, Govind Ballabh Pant Hospital, New Delhi, India
| | - Sunil K Puri
- Department of Radiology, Govind Ballabh Pant Hospital, New Delhi, India
| |
Collapse
|
16
|
Katabathina VS, Kapalczynski W, Dasyam AK, Anaya-Baez V, Menias CO. Adult choledochal cysts: current update on classification, pathogenesis, and cross-sectional imaging findings. ACTA ACUST UNITED AC 2015; 40:1971-81. [DOI: 10.1007/s00261-014-0344-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
17
|
Shah OJ, Shera A, Shah P, Robbani I. Cystic dilatation of the cystic duct: a type 6 biliary cyst. Indian J Surg 2013; 75:500-2. [PMID: 24426660 DOI: 10.1007/s12262-013-0902-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Accepted: 03/14/2013] [Indexed: 02/07/2023] Open
Abstract
Choledochal cysts of the cystic duct are extremely unusual and only single case reports are documented in the literature. The widely used Todani classification does not include such type of lesions. We present a case of a young girl with a cystic duct choledochal cyst diagnosed preoperatively and confirmed intraoperatively. Due to the site and mass effect of the cyst, excision of the lesion included a part of bile duct. Reconstruction was achieved by Roux-en-Y hepaticojejunostomy. While such lesions are extremely rare, they do occur and need to be recognized as a separate entity in the Todani classification.
Collapse
Affiliation(s)
- Omar Javed Shah
- Department of Surgical Gastroenterology, Sher-i-Kashmir Institute of Medical Sciences, Kral-Sangri, Brein, Nishat, Srinagar, Kashmir India
| | - Altaf Shera
- Department of Pediatric Surgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir India
| | - Parveen Shah
- Department of Pathology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir India
| | - Irfan Robbani
- Department of Radiodiagnosis and Imaging, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir India
| |
Collapse
|
18
|
Maheshwari P. Cystic malformation of cystic duct: 10 cases and review of literature. World J Radiol 2012; 4:413-7. [PMID: 23024843 PMCID: PMC3460229 DOI: 10.4329/wjr.v4.i9.413] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Revised: 09/02/2012] [Accepted: 09/09/2012] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate cystic malformations of the cystic duct.
METHODS: Over a 2-year period, we came across 10 cases of cystic malformation of the cystic duct among patients who were investigated in our radiology department with ultrasonography, multidetector computed tomography, or magnetic resonance imaging for abdominal complaints. Radiological diagnosis of cystic malformation of the cystic duct was made on the basis of a dilated, nonvascular cystic structure near the porta hepatis, and visualization of a clear communication with either the gallbladder, normal caliber cystic duct and/or common bile duct (CBD) on at least one imaging modality.
RESULTS: Four of 10 patients had saccular dilatation of the cystic duct. Six patients had fusiform dilatation of the cystic duct, and two of these had only mild fusiform dilatation. Two patients had associated CBD dilatation and one had associated cystic duct calculi and malignancy.
CONCLUSION: Cystic malformations of the cystic duct should be recognized as a distinct type of choledochal cyst and should be added as type VI cyst in Todani’s classification.
Collapse
|