CHOLEDOCHOCELE - CHANGING TRENDS IN DIAGNOSIS AND MANAGEMENT

Eighty-four patients with choledochocele collected from the world lite rature and one personal observation are reviewed. The main issues rega rding clinical presentation, diagnostic work-up, and the treatment of this uncommon lesion are discussed, Abdominal pain was the most common clinical feature (91% of cases), followed by pancreatitis (38%), naus ea or vomiting (35%), and jaundice (26%). In addition, associated lith iasis was found in 43% of the cases, Endoscopic retrograde cholangiopa ncreatography was the most useful diagnostic procedure and resulted in a correct diagnosis in all but one of the patients investigated by th is method, Surgical excision of the duodenal luminal portion of the ch oledochocele was the treatment most commonly used (65% of cases). In r ecent years, operative endoscopy has also been increasingly used, with good results.