Fate of Non-Excisional Surgery in Choledochal Cyst in Children

Abstract

Drainage surgery between choledochal cyst and intestine was the standard mode of treatment until mid-1980 at the Department of Pediatric Surgery, Seoul National University, Seoul, Korea. A total of eight cases were treated with by-pass surgery between 1978-80 period. From mid-1980, excision of the cyst has been used as a standard mode of surgical treatment for the choledochal cyst. Twenty one excision were carried out in 1980-1986 period. Four of those patients who received excision of cyst had received bypass surgery as a primary treatment in the past. Repeated attack of cholangitis or jaundice were the main reasons for reoperation, i.e. the excision of cyst. From 30 choledochal cyts, 11 patient received non-exicisional surgery as a primary mode of treatment. Six required reoperations including five excisions. From eight initial drainage procedures, three patients required reoperation due to morbidity from internal drainage procedure of choledochal cyst. However, there are four patient [50%1who are free from the morbidity such as cholangitis, jaundice, recurrent pain or stricture formation. The fate of cysto-jejunostomy should be closely followed for a life time to clarify the possibility of development of cancer.