Reoperation of congenital choledochal cyst: experience in 53 cases / 中国普通外科杂志

ABSTRACT

ObjectiveTo analyze the causes of and principles for reoperation of congenital choledochal cyst (CCC).MethodsDuring the period of 1986 to 2000, 120 cases of CCC were admitted to our unit,53 of them underwent reoperation. There were 33/14/2/4 cases respectively in Todani Type of Ⅰ/Ⅳa/Ⅳb and Ⅴ. First operation included simple external drainage in 17 cases, choledochoduodenostomy in 8 cases, and choledochojejunostomy with Roux en Y loop in 22 cases etc.ResultsPostoperative complications after external or internal drainage were cholangitis and hepatolithiasis, and high incidence of biliary carcinoma 19% (10/53). The mode of reoperation was mainly cyst excision with Roux Y hepaticojejunostomy (46/53).Conclusions Inappropriate surgical management of CCC incurred much complications that necessitated a reoperation. Cyst excision with reconstruction of the biliary tree by a Roux Y anastomosis is recommended as the therapy of choice for reoperation for patient with CCC.