Ann Hepatobiliary Pancreat Surg.  2023 Nov;27(4):433-436. 10.14701/ahbps.23-021.

Long-term complications after extrahepatic cyst excision for type IV-A choledochal cysts

• Anand U
• John AG
• Priyadarshi RN
• Kumar R
• Singh BN
• Parasar K
• Kumar B

• KMID: 2548511
• DOI: http://doi.org/10.14701/ahbps.23-021

Abstract

Forty-five adults with type IV-A choledochal cysts (CDC) who underwent extrahepatic cyst excision from January 2013 to December 2021 were followed up for a median interval of 25 months (range, 2 to 10 years) to observe the long-term complications in the remaining intrahepatic cyst. Late complications in varying combinations were seen in 10 patients, which included cholangitis and/or intrahepatic stones in 9 patients, intrahepatic bile duct stenosis with stones in 2 patients, anastomotic stricture in 6 patients, and left lobar atrophy with intrahepatic stones in 3 patients. Out of 6 patients who required re-do hepaticojejunostomy (HJ), three patients had left lobe atrophy with patent HJ anastomosis and a recurrent attack of cholangitis on follow-up at 3, 8, and 10 years. Complications occur frequently after extrahepatic cyst excision for type IV-A CDC and require a long-term follow-up.

Keyword

Choledochal cyst type IV; Complications; Bile duct cysts

Figure

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  Fig. 1 (A) Fluoroscopic view showing balloon dilatation of hepaticojejunostomy anastomotic stricture. (B) A coronal contrast-enhanced computed tomography image shows left lobe atrophy with mild dilatation of the left hepatic duct. The left hepatic duct is thickened due to prior episodes of cholangitis.

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