Conventional and unconventional surgical modalities for choledochal cyst: long-term follow-up

Abstract

Background This study presents our experience of various modes of presentation, surgical methods applied (both conventional and unconventional), and their outcome on patients with choledochal cyst. Method This is a retrospective study in which files of all patients with choledochal cyst over a period of 10 years (1997–2007) were studied. Data collected from files included age, sex, modes of presentation, various surgical techniques, outcome, and follow-up. Results The total number of patients was 35. The most common mode of presentation was recurrent abdominal pain in 20 (57%) patients. It was followed by jaundice in 16 (45%) patients, fever, nausea, and vomiting in 10 (28.5%) patients, and other symptoms. Roux-en-Y hepaticojejunostomy was performed in 26 (74%) patients, hepaticoduodenostomy in five (14%) patients, external T-tube drainage in three (8%) patients, and cystoduodenostomy in two (5%) patients. Two patients expired in this series. The follow-up loss was 20%. Three patients who suffered from cholangitis were managed conservatively. No patient has shown cirrhosis and cholangiocarcinoma till now. Conclusion Choledochal cyst is an important entity in an Indian setup. The presentation has a wide spectrum; therefore, different types of surgical intervention would play a significant role in various situations.

Keywords: choledochal cyst, follow-up of choledochal cyst, surgical techniques