scholarly journals Another Type of Choledochal Cyst Beyond the Todani Classification

2016 ◽  
Vol 101 (1-2) ◽  
pp. 54-57
Author(s):  
Fu-Huan Huang ◽  
Chien-Hsing Lee ◽  
Tsai-Yi Tseng ◽  
Ching-Yi Hung
Keyword(s):  
Choledochal Cyst ◽  
Cystic Duct ◽  
Distal Part ◽  
Type I ◽  
Review Of The Literature ◽  
Cystic Dilatation ◽  
Duct Cyst ◽  
The Common ◽  
Cystic Duct Cyst

The classification of choledochal cyst has changed from 3 types described by Alonso-Lej to 5 types described by Todani, but these classifications do not include dilatation of the cystic duct. The sixth type of choledochal cyst has been described by some authors for the cystic dilatation of the cystic duct. It is so rare that accurate diagnosis is difficult before operation. We present a 15-month-old girl with a type VI choledochal cyst that was misidentified preoperatively as a type I choledochal cyst. Besides the gall bladder and the cystic duct cyst, we also excised the distal part of the common bile duct and performed reconstruction with Roux-en-Y hepaticojejunostomy. From a review of the literature, we have determined that there is a more direct route to adequate diagnosis and management of the sixth type of choledochal cyst.

scholarly journals Case Report: Isolated Cystic Dilatation of the Cystic Duct: A Misdiagnosed Case Preoperatively

2021 ◽  
Vol 8 ◽  
Author(s):  
Jiankang Zhang ◽  
Zeming Hu ◽  
Xuan Lin ◽  
Dongliang Zhang ◽  
Hao Wang ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Choledochal Cyst ◽  
Cystic Duct ◽  
Extrahepatic Bile Duct ◽  
Cystic Dilatation ◽  
Liver Transaminase ◽  
Caudal Portion ◽  
The Common

A 33-year-old female with a mild elevation of liver transaminase was sent to the general surgery department for medical services due to upper-right abdominal pain for 2 weeks. A liquid dark area ~4 × 3 × 3 cm in size in the theoretical location of the pancreatic segment of the common bile duct was detected by abdominal CT with no enhancement of the cystic wall found in the enhanced CT scan. The patient was then diagnosed with a choledochal cyst based on the results of the radiological images preoperatively. During the operation, the isolated cystic dilatation was found in the middle part of the cystic duct, and its caudal portion was found behind the head of the pancreas and converged into the common bile duct at an acute angle and low insertion. According to the intraoperative evaluation, the female was then diagnosed with a cystic duct cyst (CDC). The surgery was converted to a laparotomy for the unclear structure and the possibility of anatomic variation of the bile duct. The caudal portion of the cystic duct was found communicated with the common bile duct with a narrow base, and the extrahepatic bile duct was not cystic. The CDC was removed in the surgery. One week later, the patient was discharged from the hospital for the disappearance of abdominal pain and normal liver transaminase and did not report any discomfort in the 1-month-long follow-up. The lessons drawn from this case were as follows: (1) the distinction between the relatively frequent choledochal cyst and the isolated CDC should always be taken in mind; (2) a surgical strategy should be given priority for an intraoperatively confirmed CDC; (3) a common bile duct exploration is recommended for patients with choledocholithiasis or jaundice.

scholarly journals Type IV A choledochal cyst with cystic duct cyst

HPB ◽  
2010 ◽  
Vol 12 (4) ◽  
pp. 285
Author(s):  
Supriyo Ghatak
Keyword(s):  
Choledochal Cyst ◽  
Cystic Duct ◽  
Duct Cyst ◽  
Type Iv ◽  
Cystic Duct Cyst

Laparoscopic management of type VI choledochal cyst with common bile duct stone: report of a case and review of literature

2021 ◽  
Vol 14 (10) ◽  
pp. e244393
Author(s):  
G Revathi ◽  
Brijesh Kumar Singh ◽  
Yashwant Singh Rathore ◽  
Sunil Chumber
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Choledochal Cyst ◽  
Cystic Duct ◽  
Incidental Finding ◽  
Laparoscopic Approach ◽  
Biliary Colic ◽  
Type I ◽  
Laparoscopic Management ◽  
Cyst Excision

A young adult male presented with biliary colic and intermittent jaundice for 1 year. Abdomen findings were unremarkable. Routine investigations revealed a raised total bilirubin. On abdominal ultrasonography, common bile duct (CBD) dilatation with multiple stones was noted. On further imaging with magnetic resonance cholangiopancreatography, type I choledochal cyst (CDC) was suspected. A laparoscopic approach was planned. Intraoperatively, dilatation of cystic duct was noted which constitute type VI CDC. Partial malrotation of the gut and accessory right hepatic artery were also noted as incidental finding. Laparoscopic cholecystectomy with CBD exploration and removal of stones, biliary stent placement, cystic duct cyst excision and primary repair of CBD was done. Postoperatively, the patient improved symptomatically with a fall in bilirubin to normal range. We are describing the laparoscopic management of a rare case of type IV CDC which was diagnosed intraoperatively.

Clinicopathologic classification of congenital cystic dilatation of the common bile duct

1977 ◽  
Vol 134 (5) ◽  
pp. 569-574 ◽  
Author(s):  
Yoshiro Matsumoto ◽  
Kotaro Uchida ◽  
Akira Nakase ◽  
Ichio Honjo
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Cystic Dilatation ◽  
The Common

scholarly journals A Rare Anomaly of Biliary System: MRCP Evidence of a Cystic Duct Cyst

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Cemil Goya ◽  
Mehmet Serif Arslan ◽  
Alpaslan Yavuz ◽  
Cihad Hamidi ◽  
Suzan Kuday ◽  
...  
Keyword(s):  
Cystic Duct ◽  
Clinical Symptoms ◽  
Rare Condition ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Biliary Colic ◽  
Cystic Dilatation ◽  
Duct Cyst ◽  
Abdominal Ultrasonography ◽  
Number Of Patients ◽  
The Right

Cystic duct cysts are a rare congenital anomaly. While the other bile duct cysts (choledochus and the intrahepatic bile ducts) are classified according to the classification described by Tadoni, there is no classification method described by the cystic duct cysts, although it is claimed that the cystic duct cysts may constitute a new “Type 6” category. Only a limited number of patients with cystic duct cysts have been reported in the literature. The diagnosis is usually made in the neonatal period or during childhood. The clinical symptoms are nonspecific and usually include pain in the right upper quadrant and jaundice. The condition may also present with biliary colic, cholangitis, cholelithiasis, or pancreatitis. In our case, the abdominal ultrasonography (US) performed on a 6-year-old female patient who presented with pain in the right upper quadrant pointed out an anechoic cyst at the neck of the gall bladder. Based on the magnetic resonance cholangiopancreatography (MRCP) results, a cystic dilatation was diagnosed in the cystic duct. The aim of this case-report presentation was to discuss the US and MRCP findings of the cystic dilatation of cystic duct, which is an extremely rare condition, in the light of the literature information.

scholarly journals The Arterial Supply of the Distal Part of the Pancreas

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
S. Covantev ◽  
N. Mazuruc ◽  
O. Belic
Keyword(s):  
Splenic Artery ◽  
Distal Part ◽  
Type I ◽  
Type Iv ◽  
Distal Pancreas ◽  
Corrosion Cast ◽  
Type 3

The pancreatic surgery field has evolved greatly over the previous years. Nevertheless, the vascularization of the pancreas remains a difficult subject and requires further attention. The study was conducted using macroscopical dissection and corrosion cast methods. The total number of organ blocks was 72 (50 for dissection and 22 for corrosion cast). Based on the data obtained by dissection, we can distinguish three major types of vascularization of the distal pancreas. In type one, the pancreas was vascularized only by the short branches of the splenic artery and was encountered in 18 cases (36%). In type two, the pancreas was vascularized by the long and short branches of the splenic artery and was encountered in 20 cases (40%). In type three, the pancreas was vascularized only by the long branches of the splenic artery in 12 cases (24%). Compared to that, the corrosion cast method demonstrated type 1 in 8 cases (36.36%), type 2 in 10 cases (45.46%), and type 3 in 4 cases (18.18%). During the dissection, there were no arteries to the tail of the pancreas in 13 (26%) cases, one artery in 15 (30%) cases, two arteries in 19 (38%), and three arteries in three (6%) cases. The 22 corrosion cast specimens were also evaluated based on the classification of Roman Ramos and coworkers. Type I (small arcades) was in 9 (40.90%) cases, type II (small and large arcades) was in 7 (31.82%) cases, type III (large arcades) was in 5 (22.73%) cases, and type IV (straight branches) was in 1 (4.55%) case. The corrosion cast method allowed us to determine no arteries to the tail in 4 (18.18%) cases, one artery in 6 (27.27%) cases, two arteries in 10 (45.46%) cases and three arteries in two (9.09%) cases. The vascularization of the distal part of the pancreas is highly variable and should be taken into consideration during surgery.

scholarly journals Cystic dilatation of the common bile duct in adults: report of five cases and review of literature

2000 ◽  
Vol 15 (4) ◽  
pp. 243-247
Author(s):  
Pedro Carlos Loureiro de Arruda ◽  
Antonio Roberto de Barros Coelho ◽  
José Falcão Corrêa Lima Filho ◽  
Ricardo José Caldas Machado ◽  
Ayrton Ponce de Souza ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
University Hospital ◽  
Type I ◽  
Review Of Literature ◽  
Cystic Dilatation ◽  
Endoscopic Retrograde ◽  
First Case ◽  
The Common ◽  
Todani’S Classification

The authors report five cases of cystic dilatation of the common bile duct Type I (Todani’s classification) in adults patients, in Division of General Surgery of a University Hospital, treated over a- 25-year- period from 1974 to 1999, among 16.057 operations, and not previously published. Diagnosis was obtained by operative cholangiogram (OC) in the first case, percutaneous transhepatic cholangiogram on the second one (PTHC) and by ultrasonography (US), endoscopic retrograde cholangiopancreatography (ERCP), and operative cholangiogram (OC), respectively, on the last three cases. The second patient had an adenocarcinoma arising in the cystic wall associated with peritoneal metastasis. The first two cases were treated by internal drainage and the last three by excision of the cysts and bilioenteric anastomoses. Classification, incidence, etiology, diagnosis, malignization and surgical treatment of biliary cystic disease (BCD) were revised, with the conclusion that resection must be the preferable method of treatment, when possible, especially due to the concern of malignization.

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