World Journal of
Pharmaceutical and Life Sciences

CHOLEDOCHAL CYST IN ADULTS - CLINICAL PRESENTATIONS AND MANAGEMENT-SCENARIO FROM EASTERN INDIA.

Amit Kumar Samanta, Biswarup Bose, Kakali Roy Basu, Abhimanyu Basu*

ABSTRACT

Background: a choledochal cyst (CDC) is defined as an isolated or combined congenital dilatation of the intra- and/or extra hepatic biliary tree. It is a rare disease and majority of the patients present either in their infancy or childhood. However, in nearly 20% of the patients with CDC, the diagnosis is delayed till adulthood. Here we analyze the clinical presentation, diagnosis and treatment of congenital bile duct cyst in 46 adults. Material and Methods: The clinical data of 46 patients with congenital choledochal cysts admitted from 2005 to 2011 were analyzed in the Department of Surgery, Institute of Post Graduate Medical Education & Research and SSKM Hospital, Kolkata. We also reviewed literature search (Medline) and manual cross-referencing. Results: Female patients outnumbered males. Preoperative imaging is very crucial in evaluating CDC; MRCP is our choice of imaging. Almost all cases, were attempted surgical correction of the defect i.e., complete excision and biliary reconstruction. Complications were duly taken care of and long term follow up is maintained (ongoing). Conclusion: the possibility of the disease should be kept in mind in young adults suffering from symptoms of hepatobiliary disease with dilated bile duct. MRCP is the mainstay of preoperative imaging. Cyst excision with Roux-en-Y hepaticojejunostomy is recommended as the treatment of choice for patients with type I or type IV cysts. Regular follow up is mandatory.

[Full Text Article]   [Download Certificate]