Document Detail


Choledochal cysts: age of presentation, symptoms, and late complications related to Todani's classification.
MedLine Citation:
PMID:  12407541     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The aim of this study was to compare presentation, complications, diagnosis, and treatment of choledochal cysts in pediatric and adult patients. METHODS: Forty-two patients were analyzed after subdivision into 3 groups: group A, less than 2 years (n = 10); group B, 2 to 16 years (n = 11); group C, greater than 16 years (n = 21). RESULTS: The cysts were classified as extrahepatic (n = 33), intrahepatic (n = 5), and combined (n = 4). Seventy-six percent of patients presented with abdominal pain, (20 of 21 group C), and 57% with jaundice, (10 of 10 group A). Cholangiocarcinoma occurred in 6 patients, 4 of whom had previously undergone internal drainage procedures. Excision of the extrahepatic cyst was performed in 27 of 37 patients. Five patients, of whom, 4 had cholangiocarcinoma, were beyond curative treatment at the time of diagnosis. Six patients had died at the closure of this study, 5 of them had carcinoma. CONCLUSIONS: Presenting symptoms are age dependent with jaundice prevailing in children and abdominal pain in adults. In view of the high risk of cholangiocarcinoma, early resection and not internal drainage is the appropriate treatment of extrahepatic cysts. Patients who had undergone internal drainage in the past still should undergo resection of the cyst.
Authors:
J S de Vries; S de Vries; D C Aronson; D K Bosman; E A J Rauws; A Bosma; H A Heij; D J Gouma; T M van Gulik
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  37     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2002 Nov 
Date Detail:
Created Date:  2002-10-30     Completed Date:  2002-11-27     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1568-73     Citation Subset:  IM    
Copyright Information:
Copyright 2002, Elsevier Science (USA). All rights reserved.
Affiliation:
Department of Surgery, Academic Medical Center and Vrije Universiteit Medical Center, Amsterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Abdominal Pain / epidemiology*
Adolescent
Adult
Age Distribution
Age Factors
Bile Duct Neoplasms / epidemiology
Bile Ducts, Intrahepatic
Case-Control Studies
Child
Child, Preschool
Cholangiocarcinoma / epidemiology
Choledochal Cyst / classification,  diagnosis*,  epidemiology*,  therapy
Cohort Studies
Comorbidity
Digestive System Surgical Procedures / adverse effects
Drainage
Female
Follow-Up Studies
Humans
Infant
Jaundice / epidemiology*
Liver Neoplasms / epidemiology,  secondary
Male
Netherlands / epidemiology
Prevalence
Sex Distribution
Survival Rate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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