BACKGROUND: Choledochal cysts are rare anomalies of the biliary tree and their presentation in adults is infrequent. The high incidence of associated anomalous pancreaticobiliary duct junction (APBDJ) has been well documented. However, the prevalence of APBDJ in different anatomic distribution of cysts has yet to be clarified. METHODS: A total 39 adult patients with choledochal cysts were consecutively enrolled: 22 patients had Todani type I cysts, 16 patients had type IVa cysts, and one patient had a type IVb cyst. RESULTS: No statistical differences were found in age, sex or manifestations. A higher frequency of associated APBDJ was identified in patients with type IVa cyst (100%) than those with type I cyst (P < 0.05). With a mean follow-up of 7.2 years after cyst excision, three patients with type I choledochal cyst and four with type IVa cyst have had episodes of recurrent cholangitis, all accompanied with preoperatively diagnosed APBDJ. CONCLUSION: Anomalous pancreaticobiliary duct junction has a close relationship with adult choledochal cysts, particularly type IVa. We propose the hypothesis that intrahepatic involvement results from progressive enzymatic destruction. Adult choledochal cysts in association with APBDJ, with or without intrahepatic component, should be carefully monitored.
BACKGROUND: Choledochal cysts are rare anomalies of the biliary tree and their presentation in adults is infrequent. The high incidence of associated anomalous pancreaticobiliary duct junction (APBDJ) has been well documented. However, the prevalence of APBDJ in different anatomic distribution of cysts has yet to be clarified. METHODS: A total 39 adult patients with choledochal cysts were consecutively enrolled: 22 patients had Todani type I cysts, 16 patients had type IVa cysts, and one patient had a type IVb cyst. RESULTS: No statistical differences were found in age, sex or manifestations. A higher frequency of associated APBDJ was identified in patients with type IVa cyst (100%) than those with type I cyst (P < 0.05). With a mean follow-up of 7.2 years after cyst excision, three patients with type I choledochal cyst and four with type IVa cyst have had episodes of recurrent cholangitis, all accompanied with preoperatively diagnosed APBDJ. CONCLUSION:Anomalous pancreaticobiliary duct junction has a close relationship with adult choledochal cysts, particularly type IVa. We propose the hypothesis that intrahepatic involvement results from progressive enzymatic destruction. Adult choledochal cysts in association with APBDJ, with or without intrahepatic component, should be carefully monitored.
Authors: Mehdi Ouaissi; Reza Kianmanesh; Emilia Ragot; Jacques Belghiti; Pietro Majno; Gennaro Nuzzo; Remi Dubois; Yann Revillon; Daniel Cherqui; Daniel Azoulay; Christian Letoublon; François-René Pruvot; François Paye; Patrick Rat; Karim Boudjema; Adeline Roux; Jean-Yves Mabrut; Jean-François Gigot Journal: World J Gastrointest Surg Date: 2016-06-27
Authors: Mazen Nseir; Adib A Aughsteen; Mahmood F Mahmood; Muzahim Al-Khayat; Hasan M Hawamdeh; Kamal A Bani-Hani Journal: Indian J Surg Date: 2012-07-04 Impact factor: 0.656
Authors: Georgios Antonios Margonis; Gaya Spolverato; Yuhree Kim; Hugo Marques; George Poultsides; Shishir Maithel; Luca Aldrighetti; Todd W Bauer; Nicolas Jabbour; T Clark Gamblin; Kevin Soares; Timothy M Pawlik Journal: J Gastrointest Surg Date: 2014-12-18 Impact factor: 3.452