EARLY AND LATE RESULTS OF EXCISION OF CHOLEDOCHAL CYSTS

Background/Purpose: Reports on the late results of choledochal cyst ex cision with hepaticojejunostomy in children are relatively few. Method s: Of the 84 patients who had choledochal cyst who came under our care , 79 have had definitive surgery, three are awaiting surgery, one is b eing observed with Caroli's disease, and the parents of one child have refused surgery. Thirty-eight patients treated decades ago had intern al drainage procedures. Since 1972, 41 patients have had cyst excision with hepaticojejunostomy using a 40-cm Roux loop without an antireflu x procedure. Early complications in those who underwent cyst excision with hepaticojejunostomy included anastomotic leak in three patients w ho required reoperation, cholangitis in two, and fluid collection in t he gall-bladder bed that required no intervention in one. Results: Dur ing a follow-up period ranging from 4 months to 17 years (mean, 8.5 ye ars), anastomotic structure, cholangitis, and intrahepatic stone forma tion developed in two children after being well for 8 years and over 1 1 years. These children required additional surgical procedures to ove rcome their problems. Asymptomatic intrahepatic stones 2 years after c yst excision with hepaticojejunostomy developed in a third child. Ther e was no mortality in the entire group that underwent cyst excision an d they are all enjoying a good quality of life. Conclusions: Careful, long-term follow-up is important in children who have choledochal cyst excision with hepaticojejunostomy. Copyright (C) 1997 by W.B. Saunder s Company.