Diferent Operative Procedure For Patients With Congenital Choledochal Cysts

Objective To evaluate the surgical procedure for adult patients with congenital choledochal cysts accompanied with severe cholangitis .Methods A retrospective analysis was made in 49 cases from 1998 to 2007. All the cases were confirmed diagnosis through imaging test such as B ultrasonic, CT, MRCP and ERCP. Four kinds of procedure were performed: 42cases(including 41 cases of type I cyst and 1 case of type IVB cyst) accepted cyst excision with Roux-en-y hepaticojejunostomy ,2 patients accompanied with severe cholangitis accepted external drainage before cys excision with Roux-en-y hepaticojejunostomy, 1 patient with type V cyst accepted partial hepatectomy, 1 patient with type II cyst accepted cyst excision and external drainage.Result Biliary leakage occurred on 2 patients accompanied with severe cholangitis. There was no mortality. The mean follow-up time is 5.3 years , there was no recurrent cholangitis after cyst excision with Roux-en-y hepaticcojejunostomy was performed .Conclusion Management of choledochal cysts is successful after their complete removal. cyst excision with Roux-en-y hepaticcojejunostomy is good for type I cyst and type IVB cyst;cyst excision and external drainage is appropriate for type II cyst;partial hepatectomy is optional for type V cyst, external drainage is optimal for patients accompanied with severe cholangitis before cyst excision with Roux-en-y hepaticcojejunostomy was performed.