BACKGROUND: Choledochal cysts in adults are more commonly associated with complications such as cystolithiasis, recurrent cholangitis, portal hypertension and malignancy, than in the pediatric age group. METHOD: We report a case of adult choledochal cyst with long-term complication of large stone cast and portal hypertension due to secondary biliary cirrhosis. RESULTS: A 50-year-old patient presented with obstructive jaundice and hepatosplenomegaly. On investigation, she was diagnosed as having a choledochal cyst with large stone cast and portal hypertension. Single stage resection of the choledochal cyst with Roux-en-Y hepaticojejunostomy was done by meticulous dissection and ligation of collaterals. CONCLUSION: Single stage resection of a choledochal cyst is possible in spite of associated portal hypertension, if the portal vein is patent.
BACKGROUND: Choledochal cysts in adults are more commonly associated with complications such as cystolithiasis, recurrent cholangitis, portal hypertension and malignancy, than in the pediatric age group. METHOD: We report a case of adult choledochal cyst with long-term complication of large stone cast and portal hypertension due to secondary biliary cirrhosis. RESULTS: A 50-year-old patient presented with obstructive jaundice and hepatosplenomegaly. On investigation, she was diagnosed as having a choledochal cyst with large stone cast and portal hypertension. Single stage resection of the choledochal cyst with Roux-en-Y hepaticojejunostomy was done by meticulous dissection and ligation of collaterals. CONCLUSION: Single stage resection of a choledochal cyst is possible in spite of associated portal hypertension, if the portal vein is patent.
Authors: Kevin C Soares; Dean J Arnaoutakis; Ihab Kamel; Neda Rastegar; Robert Anders; Shishir Maithel; Timothy M Pawlik Journal: J Am Coll Surg Date: 2014-06-27 Impact factor: 6.113