Choledochal cyst in children an experience at the royal medical services

Abstract EN

Objective: To evaluate our experience in the management of choledochal cyst in children at the Royal Medical Services. Methods: Nine cases of choledochal cyst were treated by the pediatric surgical section of the Royal Medical Services over a 24 year period (1979-2003).

Case material for one child was lost, leaving eight cases to be analyzed. Results: There were nine children (4 males) with age at presentation ranging from six weeks to 13 years.

The clinical presentation included jaundice, abdominal mass, and recurrent abdominal pain.

A variety of imaging modalities were used including; contrast meal intravenous cholangiogram (n=2); abdominal ultrasonography; computed tomography scanning and percutaneous cholangiography (n = 6).

A number of different types of cysts were seen including Todanis Type I (n = 7) and Type IV (n = 1).

An associated biliary Atresia was found in one case.

Cyst excision was carried out in all cases with a number of different forms of biliary reconstruction (hepaticoenterostomy with (n = 1). There was one death at 10 post-operative day due to sepsis and one bile leak, which was treated conservatively.

One child had recurrent cholangitis treated with antibiotics. Conclusion: Choledochal cyst is rare in Jordanian children and excision of the cyst with the reconstruction of biliary duct is the treatment of choice.