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  • Choledochal Cyst

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    Nico Hernández
    240 Ansichten16 Seiten
    Choledochal cyst is a cyst of the common bile duct that occurs in approximately 1 in 10,000-13,000 live births. It is more common in women and Asians. The leading theories for its etiology include a long common channel between the bile and pancreatic ducts, reflux of pancreatic enzymes, and genetic factors. Clinical presentation includes jaundice, right upper quadrant pain, and occasionally a mass. Todani classification categorizes choledochal cysts into 5 types based on anatomical location and associations. Diagnosis is made through radiology such as ultrasound, CT, or MRCP. Treatment involves total excision of the cyst and biliary reconstruction via hepaticojejunostomy Roux

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    Choledochal cyst is a cyst of the common bile duct that occurs in approximately 1 in 10,000-13,000 live births. It is more common in women and Asians. The leading theories for its etiology include a long common channel between the bile and pancreatic ducts, reflux of pancreatic enzymes, and genetic factors. Clinical presentation includes jaundice, right upper quadrant pain, and occasionally a mass. Todani classification categorizes choledochal cysts into 5 types based on anatomical location and associations. Diagnosis is made through radiology such as ultrasound, CT, or MRCP. Treatment involves total excision of the cyst and biliary reconstruction via hepaticojejunostomy Roux

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    Attribution Non-Commercial (BY-NC)
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    240 Ansichten16 Seiten

    Choledochal Cyst

    Hochgeladen von

    Nico Hernández
    Choledochal cyst is a cyst of the common bile duct that occurs in approximately 1 in 10,000-13,000 live births. It is more common in women and Asians. The leading theories for its etiology include a long common channel between the bile and pancreatic ducts, reflux of pancreatic enzymes, and genetic factors. Clinical presentation includes jaundice, right upper quadrant pain, and occasionally a mass. Todani classification categorizes choledochal cysts into 5 types based on anatomical location and associations. Diagnosis is made through radiology such as ultrasound, CT, or MRCP. Treatment involves total excision of the cyst and biliary reconstruction via hepaticojejunostomy Roux

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Als PPT, PDF, TXT herunterladen oder online auf Scribd lesen
    Markieren Sie unangemessene Inhalte
    von 16

    Choledochal Cyst

    Frans

    Definition
    Cyst of the choledocal duct Approximately 1 in 10.000-13.000 live births More common in women (3-4:1) More common in Asian (up to 1:1000) , especially in Japan

    Etiology
    Long common channel of the terminal bile duct and pancreatic duct (more than 1 cm from the sphincter) Reflux of the pancreatic enzyms Possible genetic influence, common with other anomalies (congenital hepatic fibrosis, intrahepatic biliary cysts, and polycystic kidney disease) Possible congenital duct wall anomaly

    Etiology (2)
    Weakness of the wall of the bile duct (Babbitt, 1973; Bismuth, 1999; Flanigan, 1975) Obstruction of the distal choledochus (Spitz, 1977) Combination of obstruction and weakness (Kato, 1974) Reflux of pancreatic enzymes into the CBD secondary to an anomaly of the pancreaticobiliary junction (Babbitt, 1969; Kato, 1981; Miyano, 1979; Okada, 1990; Todani, 1984, Yamashiro, 1984)

    Etiology (3)

    Clinical Presentation
    Jaundice Pain in RUQ Mass (rare)

    Todani Classification
    Type I - Cystic or fusiform dilatation of the CBD; most frequent type (90-95% of the cases). Type II - Diverticulum of the CBD, with normal size CBD Type III - Choledochocele, a cystic dilatation of the distal intramural portion of the CBD, typically protruding into the second portion of the duodenum Type IV - Cystic or fusiform dilatation of the CBD associated with cystic, fusiform, or saccular dilatation of intrahepatic bile ducts, also termed form fruste Type V - Cystic, fusiform, or saccular dilatation of the intrahepatic bile ducts associated with a normal CBD; may be associated with hepatic fibrosis (referred to as Caroli disease)

    Type

    Radiology

    Therapy
    Type I-IV Cystojejunostomy Total Excision and Cystojejunostomy Biliary reconstruction can be performed with a Roux-en-Y hepaticojejunostomy as high as possible, near the hilum of the liver (Hata, 1993; Joseph, 1990; Kasai, 1970; Miyano, 1996) Type V Hepatic Lobectomy

    Lilly Technique

    Complications
    Cholangitis Biliary stone formation Anastomotic stricture Residual debris in the intrahepatic bile ducts Intrahepatic bile duct dilatation Malignancy

    Case
    An Elsa/ P / 6 th / 10849772 / Bedah I MRS : 07-07-2008 Dx pre op : Kista Duktus Koledokus ( K82.8 ) Operation : Excisi Kista + Hepatikoyeyunostomi Roux-en-Y (5-512) Operator : dr. PW SpBA Ass : dr WDT SpB/dr ARS SpB

    Gallbladder

    Choledochal Cyst

    Cystic Duct

    Gallbladder Choledochal Cyst

    Hepaticojejunostomy Roux-en-Y

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