OUTCOME OF CHOLEDOCAL CYSTS IN ADULTS — EXPERIENCE AT TERTIARY CARE CENTRE

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Zainab Mahsal Khan
Muhammad Muslim
Adnan Ahmed
Kaleem Ullah
Nisar Ahmad
Mahmud Aurangzeb

Abstract

Objective: To find out the outcome in terms of post operative recovery, and mortality for choledochal cyst in adults in
our setup.
Materials and Methods: This was a case series study done in Surgical-A ward at Khyber Teaching Hospital, Peshawar,
Pakistan. The study was done from January 2014 to December 2016 (i.e three years period). A total of 22 diagnosed cases
of choledochal cyst above 18 years of age were included in the study. Sex, age, symptoms, surgical management and
postoperative morbidity and mortality were noted. Data was recorded in proforma and results were drawn accordingly.
Results: A total of 22 diagnosed adult cases of choledochal cyst were included in the study. Age of the study sample
ranged from 18 years to 29 years (mean age 22 years ± 2.7 SD). There were 6 (27%) males, and 16 (73%) females.
Male to female ratio was 1: 2.6. About 18 (81%) patients presented with recurrent upper abdominal pain, 20 (90%) cases
presented with jaundice, and 5 (22%) cases had fever. Ultrasound examination provided the diagnosis in 21 (95%)
cases and magnetic resonance cholangiopancreaticography was done in all patients. All the cases were subjected to
the surgical repair. Anastamosis through hepaticojejunostomy (bloomguard technique) was done in 21 (95% ) cases,
and complete cyst excision was done in only 1 (5%) patient. The histopathological report of the specimen was recorded.
Only 1 (5%) case had diagnosis of cholangiocarcinoma on histopathological examination. Out of 22 patients, only
1 (5%) patient died in post operative period owing to acute liver failure as there were deranged liver function test and
Hepatitis C status was positive in the patient. In the remaining 21 (95%) cases, post operative recovery was uneventful
and were discharged accordingly.
Conclusion: Surgical repair through cyst excision and hepaticojejunostomy, if done properly and in expert hands
ensures uneventful post operative recovery and low mortality.

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