An audit of Complicated Choledochal Cysts- 15-years' experience at a tertiary care center.

Autor: Pakkala AK; Department of Surgical Gastroenterology, Nizam's Institute of Medical Sciences, Hyderabad, India., Nekarakanti PK; Department of Surgical Gastroenterology, Nizam's Institute of Medical Sciences, Hyderabad, India., Nagari B; Department of Surgical Gastroenterology, Nizam's Institute of Medical Sciences, Hyderabad, India. nbheerappa62@gmail.com., Bansal AK; Department of Surgical Gastroenterology, Nizam's Institute of Medical Sciences, Hyderabad, India., Thumma V; Department of Surgical Gastroenterology, Nizam's Institute of Medical Sciences, Hyderabad, India., Gunturi SV; Department of Surgical Gastroenterology, Nizam's Institute of Medical Sciences, Hyderabad, India.
Jazyk: angličtina
Zdroj: Langenbeck's archives of surgery [Langenbecks Arch Surg] 2023 May 29; Vol. 408 (1), pp. 212. Date of Electronic Publication: 2023 May 29.
DOI: 10.1007/s00423-023-02952-y
Abstrakt: Purpose: Complicated choledochal cysts (CDC) have a variable presentation, and their management differs from an uncomplicated CDC. They are infrequently reported. We present our 15 years of experience in the management of complicated CDC.
Methodology: We reviewed the data of patients with CDCs managed at a tertiary level center from 2005 to 2020 from a prospectively maintained database.
Results: Of 215 patients with CDC, 123 patients presented with complicated CDC. The median age of complicated CDC was 31 years with a female preponderance (62.6%). The most common type of CDC associated with complications was type I (69.1%), followed by type IVA (29.3%). The Complicated CDC was presented as cholangitis with or without cystolithiasis (n = 45), cystolithiasis and hepatolithiasis(n = 44), malignancy(n = 10), complications associated with incomplete cyst excision (n = 10), acute pancreatitis (n = 8), chronic pancreatitis(n = 8), portal hypertension (n = 6), spontaneous rupture (n = 4), gastric outlet obstruction (n = 1). These patients were managed as a one-stage approach (52.03%) and a two-stage approach (47.96%). On univariate and multivariate analysis, increasing age, prolonged duration of symptoms, and presence of abnormal pancreaticobiliary ductal junction (APBDJ) were significantly associated with complicated CDC.
Conclusion: The management of complicated CDC varied depending on the associated pathology, many of them required a staged approach. Increasing age, prolonged duration of symptoms, and presence of APBDJ were significantly associated with complicated CDC.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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