Quistes de colédoco: un diagnóstico inadvertido. Serie de casos / Choledochal cysts: an inadvertent diagnosis. Case series

Las lesiones quísticas de vías biliares, constituyen una entidad, que rara vez se observa o diagnostica en el adulto. El motivo de este trabajo es mostrar la experiencia de un centro de referencia biliopancreática en el diagnóstico y tratamiento de quistes de colédoco. Usamos la clasificación de Todani para la descripción de los mismos. Fue un estudio Descriptivo y Retrospectivo con 502 colangiopancreatografías retrógradas endoscópicas y de ellas 20 casos de quistes de colédoco identificados mediante colangiografías de alta calidad.

Cystic lesions of the bile ducts constitute an entity that is rarely seen or diagnosed in adults. The purpose of this study is to show the experience of a biliopancreatic referral center in the diagnosis and treatment of choledochus cysts. The Todani classification was used to describe them. It was a retrospective, descriptive study of 502 endoscopic retrograde cholangiopancreatographies and of these 20 cases of choledochal cysts were identified by high-quality cholangiographies.

Diagnóstico prenatal de quiste de colédoco: presentación de un caso / Prenatal diagnosis of the choledochal cyst: case report

Clasificación de los quistes, etiología, diagnóstico y tratamiento. En el caso que se presenta se diagnosticó un quiste Tipo Ic en la semana 29 de gestación, y se confirmó el diagnóstico luego de una cesárea de urgencia en la semana 40.

Quiste de colédoco en la gestación y puerperio: reporte de dos casos y revisión de la literatura / Choledochal cyst in the pregnancy and puerperium: report of two cases and revision of literature

El quiste de colédoco consiste en la dilatación quística de la vía biliar intrahepática o extrahepática. Según la teoría mas aceptada, es causado por una anormalidad de la unión biliopancreática. Sus complicaciones más importantes son colangiocarcinoma, litiasis biliar, y pancreatitis, y su terapia es la resección quirúrgica. Sólo 20 por ciento a 30 por ciento de los casos se diagnostican en la vida adulta. Se reportan dos casos de quiste de colédoco en pacientes femeninas adultas, una de ellas al final de la gestación, y la otra puérpera. El diagnóstico de quiste de colédoco en la gestación y puerperio es un evento inusual que tiene consideraciones propias en cuanto a presentación y manejo.

A choledochal cyst is a cystic dilation of the intrahepatic or extrahepatic biliary tract. According to the most accepted theory, it is caused by an anomalous pancreatobiliary junction. The most important complications are cholangiocarcinoma, lithiasis, andpancreatitis. Current therapy is surgical resection. Only 20 per cent to 30 per cent of cases are diagnosed in adult life. Two cases of choledocal cysts are reported in female adult patients, one of them in late pregnancy and the other in puerperium. Diagnosis of choledochal cyst in pregnancy and puerperium is an uncommon event, entailing particular considerations regarding symptoms and treatment.

Long common channel syndrome as etiology of choledochal cysts and pancreatitis--two instructive cases.

The aetiology of choledochal cysts is controversial. The authors report two cases of Type I C and Type IV B choledochal cysts; both showing axial dilatation of the common bile duct and common hepatic ducts, single fusiform (Type IC) and multiple cysts of extrahepatic ducts only (Type IVB). Both had anomalous junction of the pancreaticobiliary ductal system as delineated on ERCP leading to the formation of a long common channel. Both these female patients presented in the third decade of life with 7-8 years history of repeated episodes of right upper abdominal and epigastric pain suggestive of pancreatitis. Similar pain was precipitated in both patients following ERCP with raised serum amylase. Hepatico-enterostomy gave lasting relief in both these patients.

Quistes del colédoco: revisión y presentacíon de dos niñas con quiste perforados / Choledochal cysts: review and presentation of 2 girls with perforated cyst

The clinical record is reported of two female girls, 4 1/2 and 5 1/2 years old, who were reported in 1988 at the Children's Hospital in this City with diagnosis of perforated Cholodochal supurated cyst and who were asymptomatic when they left the hospital. It is mentioned that another four patients had been operated in the same hospital, between 1981 and 1987, with choledochal cyst diagnosis

Quistes de Coledoco: presentación de 6 casos y revisión de la literatura / Choledochal cysts: presentation of 6 cases and revision of Literature

Las anomalías quísticas pueden presentarse a través de todo el árbol biliar; son raros y ocasionalmente se encuentran insospechadamente durante una cirugía. En un periodo de 3 años, encontramos 6 pacientes con quistes de colédoco los cuales fueron evaluados con colangiografía y endoscopia digestiva en el servicio de gastroenterología y endoscopia digestiva del Hospital San Ignacio. Presentamos un resumen de los casos y hacemos una revisión de la literatura

Cisto do colédoco: relato de três casos / Choledochal cyst: report of three cases

Os autores apresentam três casos de cisto do colédoco correlacionado-os a uma breve revisäo da literatura. Säo feitas consideraçöes sobre sua etiopatogênese, dificuldades diagnósticas e as alternativas de tratamento para as diferentes formas de apresentaçäo dessa entidade

ERCP in the evaluation of choledochal cyst due to anomalous pancreatobiliary junction.

With the application of endoscopic retrograde cholangio pancreatography (ERCP), the association of anomalous pancreatobiliary junction and choledochal cyst is being increasingly recognized. We describe here the ERCP findings in three patients who had this anomaly in association with fusiform (Type I) choledochal cyst. Two of our patients also had evidence of pancreatitis. The importance of ERCP in the preoperative assessment of such patients is highlighted.

Cisto gigante do colédoco tipo Ia / Giant choledochal cyst type Ia

O cisto de colédoco é definido como uma dilataçäo aneurismática do ducto hepático comum, sendo uma entidade clínica relativamente rara, mais freqüente no Japäo. A etiologia, classificaçäo e abordagem cirúrgica permanecem controvertidas. Exitem, aproximadamente, 16 hipóteses para etiologia do cisto, ente congênitas e adquiridas. Os AA däo ênfase a teoria da junçäo pancreatobiliar anômala, permitindo o refluxo de suco pancreático para o colédoco, discordando das teorias adquiridas. Revêem e atualizam a classificaçäo: tipo I, dilataçäo cística do ducto hepático comum (subdividido em três); tipo II, diverticulo do dicto hepático comum; tipo III, coledococele; tipo IV, A - cistos intra e extra-hepáticos, B - cisto extra-hepático associado a coledococele; tipo V, cistos intra-hepáticos (doença de Caroli). É apresentado um caso do tipo Ia gigante, no quel foi realizada hepaticojejunostomia em "Y" de Roux. Os AA. abordam e propöem a técnica cirúrgica adequada para cada tipo