RESUMO
BACKGROUND: Choledochal cysts in adults are more commonly associated with complications such as cystolithiasis, recurrent cholangitis, portal hypertension and malignancy, than in the pediatric age group. METHOD: We report a case of adult choledochal cyst with long-term complication of large stone cast and portal hypertension due to secondary biliary cirrhosis. RESULTS: A 50-year-old patient presented with obstructive jaundice and hepatosplenomegaly. On investigation, she was diagnosed as having a choledochal cyst with large stone cast and portal hypertension. Single stage resection of the choledochal cyst with Roux-en-Y hepaticojejunostomy was done by meticulous dissection and ligation of collaterals. CONCLUSION: Single stage resection of a choledochal cyst is possible in spite of associated portal hypertension, if the portal vein is patent.
Assuntos
Cisto do Colédoco/complicações , Cálculos Biliares/etiologia , Hipertensão Portal/etiologia , Cirrose Hepática Biliar/etiologia , Anastomose em-Y de Roux , Colangiopancreatografia por Ressonância Magnética , Cisto do Colédoco/diagnóstico , Cisto do Colédoco/cirurgia , Feminino , Cálculos Biliares/cirurgia , Humanos , Hipertensão Portal/cirurgia , Jejunostomia , Ligadura , Cirrose Hepática Biliar/cirurgia , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
The Asian Pacific Association for the Study of the Liver (APASL) set up a Working Party on Portal Hypertension in 2002, with a mandate to develop consensus guidelines on various clinical aspects of portal hypertension relevant to disease patterns and clinical practice in the Asia-Pacific region. Variceal bleeding is a consequence of portal hypertension, which, in turn, is the major complication of liver cirrhosis. Primary prophylaxis to prevent the first bleed from varices is one of the most important strategies for reducing the mortality in cirrhotic patients. Experts predominantly from the Asia-Pacific region were requested to identify the different aspects of primary prophylaxis and develop the consensus guidelines. The APASL Working Party on Portal Hypertension evaluated the various therapies that have been used for the prevention of first variceal bleeding. A 2-day meeting was held on January 12 and 13, 2007, at New Delhi, India, to discuss and finalize the consensus statements. Only those statements that were unanimously approved by the experts were accepted. These statements were circulated to all the experts and were subsequently presented at the annual conference of the APASL at Kyoto, Japan, in March 2007.
