ABSTRACT
A case of cystic congenital dilatation of hepatocholedoch, in a patient aged 27, is presented. The malformation affects the entire biliary duct, being classified as Todani Ic type. The diagnosis was intraoperatively established and the surgical solution was the quasitotal extirpation of the hepatocholedoch followed by the reconstruction of the biliary transit through hepaticojejunostomy on Y loop Roux. The postoperative evolution was favourable and the result is still good after 13 years.
Subject(s)
Choledochal Cyst/surgery , Adult , Anastomosis, Roux-en-Y , Choledochal Cyst/diagnosis , Humans , Male , Treatment OutcomeABSTRACT
Confrontation of the clinical, radiologic and morphologic data in a lot of 274 patients operated for non-lithiasic cholecystopathies during the 1966-1972 period, led to the following conclusions: - the painful choleic syndrome whose duration and frequency increase progressively, refractory to the conservative treatment, is a basic criterion in establishing the surgical treatment; - any change in the radiologic image of the gallbladder, especially those evoking a partial or totally inefficient contractile effort are of diagnostic value, suggesting the necessity of the operation, when confirmed by a similar clinical context; - the morphologic substrate consists in inflammatory lesions (infiltrations, atrophy of the mucosa, sclerosis), or degenerative lesions (cholecystoses) due to the reaction of the gallbladder walls to the irritative-chemical action of the bile hyperconcentrated by intermittent stasis caused by an incomplete cystic obstacle; - both types of lesions may determine with time obstruction of the cystic duct (acute cholecystitis), changes in the choledochoduodenal confluence (odditis), co-affection of the pancreas and liver (cholecystopancreatitis, chronic reactive hepatitis); - the late results lend support to the surgical treatment in such circumstances.
