Congenital choledochal cyst with pancreatitis

Objective To understand the relationship among congenital choledochal cyst, anomalous junction of pancreaticobiliary duct (AJPBD) and pancreatitis. Methods 25 children with choledochal cyst treated in our hospital were incl uded in this study. Their ages ranged from 2 months to 14 years. Intraopera tive cholangiography was performed in 24 children. Pancreatic samples obtai ned from the head and body of the pancreas at operation were observed under light and electron microscope. Serum amylase was analyzed one week before and after operation respectively. Bile amylase in the cyst and gallbladder was measured at operation. Results The incidence of AJPBD was 70%. Inflammatory cell infiltration and fibrous hyperplasia were seen in the pancreatic specimens of 5 children, of whom 4 had AJPBD. No ultrastructural changes were found in 2 children with out AJPBD, white different changes were seen in 6 with AJPBD, including tho se showing no pathological changes under light microscope. All the changes became more severe as the age of the patient increased. The bile and serum amylase levels were higher in children with AJPBD than those without AJPBD (P < 0.05). Conclusion Congenital choledochal cyst has a close relationship with AJPBD and pancreatitis. Pancreatic pathological changes have a long and chronic c ourse from ultrastructural changes to macroscopic changes for the developin g of pancreatitis.