Clinical Characteristics, Diagnosis And Treatment Of Congenital Choledochal Cyst In Infants And Children

objective:Analysis the clinical feature,pathology,diagnosis,treatment,and surgical complications of different types of congenital choledochal cyst,to guide the diagnosis and treatment of the disease in the future.Materials and Methods:There is86patients from2003to2011.We divided them into the infant group (from3months to3years,11males and35females)and the children group (from3years to14years,9males and31females) by the age.And then compared the symptoms, imaging studies,transaminases, bilirubins, surgical conditions and liver pathologies between the two groups.Results:the infant group VS the children group:Jaundice (73.9%VS40.0%, P=0.01); Fever(54.5%VS50.0%, P=0.841); Abdominal pain(32.6%VS60.0%, P=0.011); White clay-like stool (21.7%VS2.5%, P=0.009); Abdominal mass (52.2%VS17.5%, P=0.001); Mis-diagnosed (26.1%VS7.5%, P=0.002); Triad (10.9%VS15.0%, P=0.567; B ultrasound (95.7%VS97.5%, P=0.553); CT(97.8%VS97.5%, P=0.717); Elevated bilirubin(80.4%VS62.5%, P=0.064); Elevated transaminase (86.7%VS68.2%, P=0.03); Cirrhosis of the liver (34.8%VS15.0%, P=0.036); The two groups of type I choledochal cyst in infants and young children group,33cases(80.5%) for the cystic type, children's group,21cases (58.3%) for the fusiform type, the two groups, P=0.000. Infant group,45cases (97.8%) of the common bile duct cyst excision, hepatic duct jejunalRoux-en-Y anastomosis, postoperative recurrent cholangitis one cases of biliary fistulawith wound dehiscence1cases,1case (2.2%) purely within the drainage line, the cystduodenal anastomosis, postoperative recurrent cholangitis, and improved by the anti-inflammatory treatment, children's group of40patients (100%) all trekking choledochal cyst resection, hepatic duct jejunum Roux-en-Y anastomosis, postoperative recurrentcholangitis1cases. All cases, no deaths. The complication rate, P=0.620. We followed up62patients in total. In the infant group(34patients), there are,1(2.9%) having abdominal pains and2cases (5.9%) having the liver function abnormalities; in the other group (28patients),1case (3.6%), having abdominal pain,and1case (3.6%)having the liver function abnormalities.Conclusion:1. choledochal cyst in infants and children is more common diseases, the prognosis is good.2.Infant obstructionearly clinical manifestations of jaundice, abdominal mass, whiteclay stool-based, type I choledochal cyst cystic type; children with abdominal pain, type I choledochal cyst in the fusiform type Lord.3.Infants transaminase abnormalities and pathological damage, serious than the children's group, but early diagnosis of infants and young children, early surgical treatment of the lifting of the biliary obstruction, liver damage recoverable.4.B ultrasound and CT clear of the disease and its sub-type to guide surgery. B ultrasound can be used as early detection ofbile duct cysts of the examination method of choice.5. Infants and children's surgical approach to bile duct cyst excision jejuna Roux-en-Y anastomosis based.6.Cyst removal of bile ductjejunum Roux-en-Y anastomosis is widely recognized as the most appropriate surgery, less complications, long-term complications need to be further follow-up observation.