Total cyst excision with Roux-en-Y hepaticojejunostomy for choledochal cyst management: a single-center experience

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Abstract

Background
Choledochal cystis considered as a cystic dilatation of the biliary tract, which is a rare disease. It is more common in children, but its incidence and diagnosis are increasing in adults, representing 20% of the cases.
Aim
To evaluate morbidity and mortality rates following hepaticojejunostomy done for patients, either child or adult, with choledochal cyst.
Patients and methods
A total of 30 patients were evaluated, comprising 13 children and 17 adults. The study was done in the period from January 2013 till January 2020, in the Advanced Hepato-Pancreatico-Biliary Center, Zagazig University Hospital, Egypt.
Results
Abdominal pain was the commonest complaint in all patients. Jaundice was present in 80%. Total cyst resection with reconstruction of the biliary tract with a standard 60–60 cm Roux-en-Y hepaticojejunostomy was done in 28 (93.33%) patients. Left hepatectomy was done in two patients with Caroli’s disease. There was no recurrence in our follow-up period.
Conclusion
Total cyst excision with Roux-en-Y hepaticojejunostomy is the standard treatment of choledochal cyst. It was associated with low incidence of recurrence and also decreased long-term postoperative complications and malignancy.

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