Surgery Today

, Volume 26, Issue 4, pp 281–285 | Cite as

Choledochocele: Changing trends in diagnosis and management

  • Riccardo Masetti
  • Armando Antinori
  • Roberto Coppola
  • Claudio Coco
  • Claudio Mattana
  • Antonio Crucitti
  • Antonio La Greca
  • Guido Fadda
  • Paolo Magistrelli
  • Aurelio Picciochi
Case Reports

Abstract

Eighty-four patients with choledochocele collected from the world literature and one personal observation are reviewed. The main issues regarding clinical presentation, diagnostic work-up, and the treatment of this uncommon lesion are discussed. Abdominal pain was the most common clinical feature (91% of cases), followed by pancreatitis (38%), nausea or vomiting (35%), and jaundice (26%). In addition, associated lithiasis was found in 43% of the cases. Endoscopic retrograde cholangiopancreatography was the most useful diagnostic procedure and resulted in a correct diagnosis in all but one of the patients investigated by this method. Surgical excision of the duodenal luminal portion of the choledochocele was the treatment most commonly used (65% of cases). In recent years, operative endoscopy has also been increasingly used, with good results.

Key Words

choledochocele choledochal cysts diagnostic sensitivity surgical treatment endoscopic treatment 

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References

  1. 1.
    Flanigan DP (1975) Biliary cysts. Ann Surg 182:635–643Google Scholar
  2. 2.
    Yamaguchi M (1980) Congenital choledochal cyst: Analysis of 1,433 patients in the Japanese literature. Am J Surg 140:653–657Google Scholar
  3. 3.
    Scholz FJ, Carrera GF, Larsen CR (1976) The choledochocele: Correlation of radiological, clinical and pathological findings. Radiology 118:25–28Google Scholar
  4. 4.
    Venu RP, Geenen JE, Hogan WJ, Dodds WJ, Wilson SW, Stewart ET, Soergel KH (1984) Role of endoscopic retrograde cholangiopancreatography in the diagnosis and treatment of choledochocele. Gastroenterology 87:1144–1149Google Scholar
  5. 5.
    Sarris GE, Tsang D (1989) Choledochocele: Case report, literature review and a proposed classification. Surgery 105:408–413Google Scholar
  6. 6.
    Martin RF, Biber BP, Bosco JJ, Howell DA (1992) Symptomatic choledochoceles in adults: Endoscopic retrograde cholangiopancreatography, recognition and management. Arch Surg 127:536–539Google Scholar
  7. 7.
    Becker CD, Nagy AG, Gibney RG, Burhenne HJ (1987) Diagnosis and treatment of choledochocele complicated by choledocholithiasis (case report). Gastrointest Radiol 12:322–324Google Scholar
  8. 8.
    Kagiyama S, Okazaki K, Yamamoto Y, Yamamoto Y (1987). Anatomic variants of choledochocele and manometric measurements of pressure in the cele and the orifice zone. Am J Gastroenterol 82:641–649Google Scholar
  9. 9.
    Pollack M, Shirkhoda A, Charnsangavej C (1985) Computed tomography of choledochocele. J Comput Assist Tomogr 9:360–362Google Scholar
  10. 10.
    Ozawa K, Yamada T, Matumoto Y, Tobe R (1980) Carcinoma arising in a choledochocele. Cancer 45:195–197Google Scholar
  11. 11.
    Donald JJ, Coral A, Lees WR (1989) Choledochocele complicated by carcinoma. Clin Radiol 40:101–103Google Scholar
  12. 12.
    Pisano G, Donlon JB, Platell C, Hall JC (1991) Cholangiocarcinoma in a type III choledochal cyst. Aust N Z J Surg 61:855–857Google Scholar
  13. 13.
    Dehyle P, Schnaars P, Meyer HJ (1974) Perorale endoskopischelektrochirurgische Abtragung einer Choledochocele. Dtsch Med Wochenschr 99:71–72Google Scholar
  14. 14.
    Nagasawa S, Tanaka M, Seki H (1983) Two cases of choledochocele: Therapeutic trial of endoscopic papillotomy (in Japanese). Jpn J Gastroenterol 80:1490–1495Google Scholar

Copyright information

© Springer-Verlag 1996

Authors and Affiliations

  • Riccardo Masetti
    • 1
  • Armando Antinori
    • 1
  • Roberto Coppola
    • 1
  • Claudio Coco
    • 1
  • Claudio Mattana
    • 1
  • Antonio Crucitti
    • 1
  • Antonio La Greca
    • 1
  • Guido Fadda
    • 2
  • Paolo Magistrelli
    • 1
  • Aurelio Picciochi
    • 1
  1. 1.Department of SurgeryCatholic University of Rome, Policlinico Universitario “A. Gemelli”RomeItaly
  2. 2.Department of PathologyCatholic University of Rome, Policlinico Universitario “A. Gemelli”RomeItaly

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