Choledochal Cysts Follow-up

  • Author: Michael AJ Sawyer, MD; Chief Editor: Julian Katz, MD   more...
 
Updated: Jan 4, 2012
 

Further Outpatient Care

  • Patients need lifelong follow-up because of the increased risk of cholangiocarcinoma, even after complete excision of the cyst.
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Complications

  • Patients undergoing excision of a choledochal cyst are subject to the usual complications associated with surgery, including hemorrhage, wound infection, bowel obstruction, and thrombotic complications.
  • Postoperatively, patients are at risk of developing pancreatitis and ascending cholangitis.
  • Late postoperative complications include development of intrahepatic bile duct stones and cholangiocarcinoma.
  • Adult patients with long-standing subclinical ductal inflammation and biliary stasis may develop one or more of the following complications: hepatic abscesses, cirrhosis, portal hypertension, recurrent pancreatitis, and cholelithiasis.
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Prognosis

  • The prognosis after excision of a choledochal cyst is usually excellent (see Further Outpatient Care).
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Patient Education

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Contributor Information and Disclosures
Author

Michael AJ Sawyer, MD  Consulting Staff, Department of Surgery, Southwestern Medical Center; Consulting Staff, Department of Surgery, Comanche County Memorial Hospital; Consulting Staff, Great Plains Surgical Clinic, Inc

Michael AJ Sawyer, MD is a member of the following medical societies: American College of Surgeons, Society for Surgery of the Alimentary Tract, Society of American Gastrointestinal and Endoscopic Surgeons, and Society of Laparoendoscopic Surgeons

Disclosure: Nothing to disclose.

Coauthor(s)

Tarak H Patel, MD  Consulting Surgeon, Department of Surgery, Reynolds Army Medical Center, Fort Sill

Disclosure: Nothing to disclose.

Thomas F Murphy, MD  Chief of Abdominal Imaging Section, Department of Radiology, Tripler Army Medical Center

Disclosure: Nothing to disclose.

Fernando V Ona, MD  Associate Professor, John A Burns School of Medicine, Phillipines; Chief, Center for Digestive and Liver Diseases, Nutrition, University of Hawaii; Professor, St Luke's College of Medicine, Veterans Administration Medical Center

Fernando V Ona, MD is a member of the following medical societies: American Gastroenterological Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Mounzer Al Al Samman, MD  Department of Internal Medicine, Division of Gastroenterology, Assistant Professor, Texas Tech University School of Medicine

Mounzer Al Al Samman, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, and American Gastroenterological Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

BS Anand, MD  Professor, Department of Internal Medicine, Division of Gastroenterology, Baylor College of Medicine

BS Anand, MD is a member of the following medical societies: American Association for the Study of Liver Diseases, American College of Gastroenterology, American Gastroenterological Association, and American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Alex J Mechaber, MD, FACP  Senior Associate Dean for Undergraduate Medical Education, Associate Professor of Medicine, University of Miami Miller School of Medicine

Alex J Mechaber, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, and Society of General Internal Medicine

Disclosure: Nothing to disclose.

Chief Editor

Julian Katz, MD  Clinical Professor of Medicine, Drexel University College of Medicine

Julian Katz, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Geriatrics Society, American Medical Association, American Society for Gastrointestinal Endoscopy, American Society of Law, Medicine & Ethics, American Trauma Society, Association of American Medical Colleges, and Physicians for Social Responsibility

Disclosure: Nothing to disclose.

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Operative specimen of type I choledochal cyst.
Type I choledochal cyst.
Type II choledochal cyst.
Type III choledochal cyst (choledochocele).
Type IV choledochal cyst (extrahepatic and intrahepatic disease).
Type V choledochal cyst (intrahepatic, Caroli disease).
Nuclear medicine scan of choledochal cyst.
Nuclear medicine scan of choledochal cyst.
Nuclear medicine scan of choledochal cyst.
Computed tomography (CT) scan of choledochal cyst demonstrating intrahepatic extension involving the main left hepatic duct.
Computed tomography (CT) scan of choledochal cyst involving the common hepatic duct.
Computed tomography (CT) scan demonstrating large choledochal cyst and adjacent gall bladder.
Computed tomography (CT) scan of large, saccular type I choledochal cyst.
Diagnostic ultrasonogram demonstrating type I choledochal cyst in a 4-month-old child presenting with hyperbilirubinemia and transaminase elevations.
Intraoperative cholangiogram of type I choledochal cyst.
Roux-en-Y hepaticojejunostomy to restore biliary-enteric continuity following resection of choledochal cyst.
 
 
 
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