All issues > Volume 31(10); 1988

Original Article

J Korean Pediatr Soc. 1988;31(10):1281-1289. Published online October 31, 1988.

A Clinical Study of Congenital Choledochal Cyst.

Kyoung Mi Park¹, Ki Sup Chung¹, Eui Ho Hwang²

¹Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
²Department of Pediatric Surgery, Yonsei University College of Medicine, Seoul, Korea

Received: March 2, 1988;  Accepted: May 9, 1988.

Abstract

A clinical study of 24 patients with congenital choledochal cyst who had been admitted to Severance Hospital, Yonsei University College of Medicine during the 16 year peroid from January, 1971 to December, 1986 was done. The results were as follows; 1) Of the 24 cases studied, the highest incidence of this cyst, 15 cases (62.5%), was found in children younger than 10 years of age. The male to female ratio was 1:3, with 6 male and 18 female patients. 2) Presenting symptoms and signs were variable with abdominal pain in 19 cases (79.2%), jaundice in 17 cases(70.8%), hepatomegaly in 13 cases(54.2%), vomiting in 12 cases(50.0%), and abdominal mass in 6 cases(25.0%). Only 3 cases presented with the classic symptom triad. 3) Laboratory findings revealed SGOT and SGPT elevation in 20 cases(83.3%), serum bilirubin elevation in 18 cases(78.3%), and ALP elevation in 18 cases(78.3%). Abdominal ultrasongraphy which yielded 94.1% diagnostic accuracy can be regarded as the most useful diagnostic method considering its safety and simplicity. 4) Morphologic classification of the choledochal cyst showed A type as the most common type with 16 cases(66.7%) according to the Alonso-Lej classifciation, but according to the Todani classification, I type was the most common type with 13 cases(54.1%). 5) Twenty of the 24 cases underwent surgery. Cystectomy and Roux-en-Y choledochoenterostomy were done in 10 cases. There were 5 cases of immediate postoperative complication with cholangitis, being the most common complication occuring in 2 cases. There was no mortality associated with the surgery. 6) Longterm complications associated with the choledochal cyst were liver cirrhosis in 4 cases, gall stone in 2 cases, and one case each of empyema of the gall bladder, and pancreatitis. There was one case each of congenital biliary atreisa and neonatal hepatitis as accompanying disease.

Keywords :Choledochal cyst