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Choledochal cyst

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https://www.readbyqxmd.com/read/29323060/spectrum-of-hepatobiliary-cystic-lesions-a-7-year-experience-at-a-tertiary-care-referral-center-in-north-india-and-review-of-literature
#1
Prasenjit Das, Pragya Sharma, Tripti Nakra, Shouriyo Ghosh, Rajni Yadav, Brijnandan Gupta, Gaurav Khanna, K S Madhusudhan, Rajesh Panwar, M K Anoop, Ragini Kilambi, Anand N Singh, Nihar R Dash, Sujoy Pal, Siddhartha Datta Gupta
CONTEXT: Cysts arising from the hepatobiliary tree are a group of heterogeneous lesions with regard to pathogenesis, clinical presentation, and radiological finding. They can be intrahepatic or extrahepatic, developmental, secondary to infective/inflammatory etiologies, as well as neoplastic. This study was conducted to determine the spectrum of hepatobiliary cysts in surgically intervened cases, with regard to their prevalence, histological spectrum, and clinicoradiological correlation, wherever possible...
October 2017: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/29322850/clinical-significance-of-intrapancreatic-choledochal-cyst-excision-in-surgical-management-of-type-i-choledochal-cyst
#2
Fei Fan, Da-Peng Xu, Zheng-Xiang Xiong, Hai-Jia Li, Hai-Bei Xin, Huan Zhao, Jin-Wei Zhang
Objective To investigate the effectiveness of intrapancreatic choledochal cyst excision in treating type I choledochal cyst, and increase understanding of the need for thorough surgical management of the disease. Methods Primary and secondary (including multiple) surgical cases, treated between 2005 and 2015, were retrospectively analysed, and follow-up data of post-treatment effectiveness to date were reviewed. Differences in curative effects were compared between whole and partial excision of the choledochal cyst...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29312974/robotic-assisted-excision-of-type-i-choledochal-cyst-with-roux-en-y-hepaticojejunostomy-reconstruction
#3
EDITORIAL
Shin-E Wang, Shih-Chin Chen, Bor-Uei Shyr, Yi-Ming Shyr
Choledochal cyst is a relatively rare congenital disease. The current standard treatment of choice for choledochal cyst is complete excision with Roux-en-y hepaticojejunostomy due to possible associated complications if left untreated, such as cholangitis, pancreatitis, cirrhosis, portal hypertension, and biliary malignancy. Traditionally, the resection for choledochal cyst is carried out with open surgery because of complex dissection and bilioenteric reconstruction. Recently, minimal invasive approach has gain wide interest, especially with the use of robotic surgical systems which can facilitate complex minimal access procedures...
December 2017: Hepatobiliary Surgery and Nutrition
https://www.readbyqxmd.com/read/29290919/cystic-metastasis-from-a-mucinous-adenocarcinoma-of-duodenum-mimicking-type-ii-choledochal-cyst-a-case-report
#4
Yo Na Kim, Ji Soo Song
A 51-year-old male patient was referred to our hospital because of an incidentally detected cystic mass near the common bile duct (CBD). Imaging studies demonstrated a cystic mass that was suspected to communicate with the CBD. Gastroscopy showed irregular mucosal thickening with hyperemic change in the second portion of the duodenum. A type II choledochal cyst combined with duodenal malignancy was suspected. The patient underwent surgical resection and the histological diagnosis was mucinous adenocarcinoma of the duodenum with cystic metastasis...
December 15, 2017: World Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/29181996/choledochal-cyst-of-the-proximal-cystic-duct-a-taxonomical-and-therapeutic-conundrum
#5
R Kilambi, A N Singh, K S Madhusudhan, P Das, S Pal
Isolated choledochal cysts involving the cystic duct are rare. We present a case of a choledochal cyst involving only the proximal cystic duct, and discuss the taxonomic and therapeutic challenges. There is a need for a clearly defined classification system for these cysts as they may be categorised as either type II or type VI cysts. The optimal treatment remains debatable, with some authors recommending a bilioenteric reconstruction owing to the wide cystic duct-bile duct junction. However, we suggest that a cholecystectomy should be performed with examination of the specimen and frozen section in case of any abnormality rather than upfront bile duct excision...
November 28, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29127962/minimally-invasive-hepatobiliary-surgery
#6
REVIEW
Omid Madadi-Sanjani, Claus Petersen, Benno Ure
Comparative studies and large-scale case series that confirm the advantages of laparoscopy in children with hepatobiliary diseases are scarce, and the use of laparoscopy remains a matter of debate. This article reviews the current literature on the role of laparoscopic and robotic surgery in pediatric patients with choledochal cyst, biliary atresia, gallbladder diseases, and hepatobiliary malignancies. Studies were identified through a search of the MEDLINE database. Laparoscopy may be beneficial for resection of choledochal cyst and cholecystectomy...
December 2017: Clinics in Perinatology
https://www.readbyqxmd.com/read/29105184/differentiation-between-cystic-biliary-atresia-and-choledochal-cyst-a-retrospective-analysis
#7
Jue Tang, Dan Zhang, Wei Liu, Ji-Xiao Zeng, Jia-Kang Yu, Yi Gao
AIM: Cystic biliary atresia (CBA) can be easily misdiagnosed as choledochal cyst (CC). Some patients have already progressed to severe liver fibrosis and missed the optimal surgical time, when the differential diagnosis is made. We aim to determine the differentiation between CBA and CC, and to validate the value of aspartate aminotransferase-to-platelet ratio index (APRI) in the assessment of liver fibrosis and prediction of post-operative outcome for infants with biliary cystic malformations (BCMs)...
November 3, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29089716/robotic-roux-en-y-bilioenteric-reconstruction
#8
Sanjay Goja, Manoj K Singh, Sujeet Saha, Varun Mahabaleshwar, Arvinder S Soin
The authors report technical details of robotic bilioenteric reconstruction done for variable indications: choledochal cyst and biliary stricture. Robotic bilioenteric anastomosis as alternative to open reconstruction, offers advantages of minimal access surgery without compromising the precision of open surgery for hilar dissection and reconstruction. Both patients recovered uneventfully and remain symptom-free 18 and 15 months after surgery.
October 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/29089712/management-of-complicated-choledochal-cyst-in-an-adult-with-situs-inversus-totalis-diagnostic-difficulties-and-technical-notes
#9
Ajeet Pratap Maurya, Saket Kumar, Vishal Gupta, Abhijit Chandra
Situs inversus totalis is the mirror image of situs solitus, the normal position of abdominal and thoracic viscera. Many associated intraabdominal anomalies have been described with this condition. However, association of choledochal cyst with situs inversus has never been reported. Diagnosis and surgical procedures for abdominal pathology in patients with situs inversus totalis are technically more complicated and pose unique challenges because of left-right transposition of the visceral organs. The choledochal cyst is usually diagnosed in the neonatal period or during childhood...
October 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/29089679/embryonal-rhabdomyosarcoma-of-the-biliary-tree-a-rare-cause-of-obstructive-jaundice-in-children-which-can-mimic-choledochal-cysts
#10
Dhara J Kinariwala, Andrew Y Wang, Patrick D Melmer, William P McCullough
Jaundice in children is more often due to hepatic disease than obstruction. Differential considerations for obstructive jaundice in children include choledocholithiasis, choledochal cysts and rare neoplasms. Rhabdomyosarcoma, the most common soft tissue sarcoma in pediatric patients, typically involves the head and neck, genitourinary system and extremities. Embryonal rhabdomyosarcoma of the biliary tree is a rare entity. We present a 3-year-old boy with abrupt onset obstructive jaundice. Although initial imaging suggested a dilated biliary system with fusiform common bile duct, sludge, and possible cholelithiasis, endoscopic retrograde cholangiopancreatogram (ERCP) diagnosed a common bile duct embryonal rhabdomyosarcoma and further imaging showed involvement of the cystic duct...
July 2017: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/29049233/pediatric-types-i-and-vi-choledochal-cysts-complicated-with-acute-pancreatitis-and-spontaneous-perforation-a-case-report-and-literature-review
#11
Ching-Chung Tsai, Po-Kai Huang, Hsien-Kuan Liu, Yu-Tsun Su, Ming-Chun Yang, Ming-Lun Yeh
RATIONALE: Choledochal cysts are a congenital disorder of the common bile duct that can cause progressive biliary obstruction and biliary cirrhosis. They were classified by Todani into five types. Of these, type VI choledochal cysts are rarely reported in the literature. PATIENT CONCERNS: A 22-month-old girl presented with intermittent epigastralgia for approximately 10 days and fever for three days. Fasting and total parenteral nutrition were administered after admission...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28979631/primary-hydatid-cyst-of-the-pancreas-of-the-child-a-case-report
#12
Achraf El Bakkaly, Nour Merouane, Omar Dalero, Houda Oubeja, Mounir Erraji, Fouad Ettayebi, Hicham Zerhouni
Primary pancreatic hydatid lesions are very rare with an incidence of less than 1% in the adult population. We report an observation of a 5-year-old girl who consulted for isolated abdominal pain occurring for 2 weeks without vomiting, transit disorders or jaundice and evolving in a context of conservation of the general condition and apyrexia. Clinical examination and preoperative imaging have suggested the diagnosis of a choledochal cyst or duodenal duplication rather than a hydatid cyst of the pancreas due to the presence of a cystic hepatic image projecting into the liver hilum...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28940454/choledochal-cyst-with-17q12-chromosomal-duplication
#13
Radana Kotalova, Petra Dusatkova, Jana Drabova, Lenka Elblova, Tomas Dedic, Ondrej Cinek, Jan Lebl, Stepanka Pruhova
The 17q12 chromosomal region carries the HNF1B gene, mutations of which cause various conditions. When searching for HNF1B/17q12 rearrangements among children with biliary atresia and/or choledochal cysts, we identified a male proband carrying a 17q12 duplication spanning 1698 kb that included 24 genes from TBC1D3C to HNF1B. The boy presented with cholestatic jaundice at the age of 2 weeks due to a choledochal cyst sized 15 ×12 mm (type Ia according to the Todani classification). He underwent a shunt surgery consisting of a hepaticojejunostomy using Roux-en-Y loop at the age of 2 months, which led to a permanent relief of cholestasis...
January 2018: Annals of Human Genetics
https://www.readbyqxmd.com/read/28927985/the-efficacy-of-resection-of-intrahepatic-bile-duct-stenosis-causing-membrane-or-septum-for-preventing-hepatolithiasis-after-choledochal-cyst-excision
#14
Yujiro Tanaka, Takahisa Tainaka, Wataru Sumida, Chiyoe Shirota, Akinari Hinoki, Naruhiko Murase, Kazuo Oshima, Ryo Shirotsuki, Kosuke Chiba, Hiroo Uchida
BACKGROUND/PURPOSE: We previously found that many patients who developed hepatolithiasis after choledochal cyst excisions had intrahepatic bile duct stenosis (IHBDS). In 1992, we started resection of the membrane or septum which was found at the site of IHBDS during choledochal cyst excisions. Since intrahepatic stones usually take years to form, the efficacy of this procedure has not been proved. METHODS: The records of patients who had IHBDS-causing membrane or septum and underwent choledochal cyst excision with Roux-Y hepaticojejunostomy between January 1979 and December 2006 were retrospectively analyzed...
September 5, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28905807/buttressing-hepaticojejunostomy-apos-s-with-hepatic-round-ligament-flap-may-be-beneficial
#15
Jayant Kumar Banerjee, Ramanathan Saranga Bharathi, Pankaj Purushotam Rao
BACKGROUND: Bile leaks and anastomotic strictures are important complications of hepaticojejunostomy (HJ). Evidence suggests that the use of hepatic round ligament (HRL) to buttress HJ may be beneficial. This study evaluates the feasibility of this approach. METHODS: HJs performed over 2 years (Jun 2014- May 2016), with HRL reinforcement, were analyzed. Operative outcomes measured included technical difficulty, blood loss, time necessary for flap harvest, and reinforcement of HJ...
August 31, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28902846/downregulation-of-microrna-145-may-contribute-to-liver-fibrosis-in-biliary-atresia-by-targeting-add3
#16
Yongqin Ye, Zhihan Li, Qi Feng, Zimin Chen, Zhouguang Wu, Jianyao Wang, Xiaoshuo Ye, Dahao Zhang, Lei Liu, Wei Gao, Lihui Zhang, Bin Wang
BACKGROUND AND OBJECTIVES: Biliary atresia (BA) is a pediatric liver disease characterized by fibro-obliteration and obstruction of the extrahepatic biliary system, that invariably leads to cirrhosis and even death, if left untreated for extended time. However, its pathology and etiology still remained unknown. In this study, we tested the expression of adducin 3 (ADD3), the gene identified as a susceptibility gene in BA by GWAS, and uncovered its upstream regulatory microRNA in the pathogenesis of BA...
2017: PloS One
https://www.readbyqxmd.com/read/28892977/external-drainage-of-giant-infantile-choledochal-cyst-before-definitive-repair-is-it-worth
#17
Vijai Datta Upadhyaya, Basant Kumar, Sandeep Kumar Raut, Eti Sthapak
Infantile Choledochal Cysts (IFCC) usually present with jaundice, acholic stool and abdominal lump or abdominal distension. If the surgical intervention is delayed, they rapidly progress to liver fibrosis which is considered to be irreversible if progressed to cirrhosis. We present the data of four cases (aged one month to seven months) of IFCC presented with cholangitis managed in one surgical unit in last two years. In one case, cholangitis was treated with prolonged antibiotic course before definitive repair whereas in rest, external drainage of cyst was done in addition to intravenous antibiotic to treat cholangitis...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28872095/laparoscopic-excision-of-the-choledochal-cyst-in-adult-patients-an-experience
#18
Hirdaya Hulas Nag, Kshitij Sisodia, Pushap Sheetal, Hari Govind, Som Chandra
BACKGROUND: Laparoscopic choledochal cyst excision (LCCE) in adult patients is not common. AIMS: The aim is to report our experience of LCCE in adult patients. PATIENTS AND METHODS: This study includes a retrospective review of twenty adult patients (age >18 years) with choledochal cyst (CC) who underwent LCCE by a single surgical team from February 2011 to April 2016. RESULTS: The mean age was 45.5 years. Nineteen (95%) patients had Type-I CC, and one patient (5%) had Type-IV CC (Todani's classification)...
October 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28844549/pancreatic-heterotropia-in-wall-of-extra-hepatic-choledochal-cysts-a-retrospective-analysis-of-thirteen-of-such-cases-from-north-india
#19
Pragya Sharma, Tripti Nakra, Gaurav Khanna, Rajni Yadav, Rajesh Panwar, Madhusudhan Ks, Khushbu Khetan, Nihar R Dash, Sujoy Pal, Peush Sahni, Siddhartha Datta Gupta, Prasenjit Das
INTRODUCTION: Heterotopic pancreas (HP) has rarely been identified in the wall of choledochal cyst (CC). METHODS: Retrospectively we screened 200 excised specimens of CC received at our Institute over a period of last eight years and looked for presence of HP rests in them. All the specimens were processed in their entirety. RESULT: HP was identified in the wall of 13 (6.5%) CCs, out of which 11 were Heinrich Type 2, and two were Heinrich Type 1...
July 25, 2017: Pathology, Research and Practice
https://www.readbyqxmd.com/read/28774506/single-stage-operation-for-perforated-choledochal-cyst
#20
Go Ohba, Hiroshi Yamamoto, Masato Nakayama, Shohei Honda, Akinobu Taketomi
BACKGROUND: The option of either single- or two-staged cyst excision has been proposed for perforated choledochal cysts (CCs), but which of the two methods is more effective remains controversial. We examined the complications and short-term outcomes of single-stage excision of perforated and non-perforated CCs. METHODS: The medical records of patients treated for CCs from 2003 to 2016 were retrospectively reviewed. Outcomes were compared between patients with perforated CCs (Group A) and non-perforated CCs (Group B)...
July 21, 2017: Journal of Pediatric Surgery
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