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Cholédococèle traité par sphinctérotomie endoscopique: à propos d’un cas

A case of choledococele treated successfully by endoscopic sphincterotomy

Résumé

Le cholédococèle est un sous-type rare des dilatations kystiques du cholédoque. Plusieurs options thérapeutiques sont possibles, chirurgicale et endoscopique.

But

Rapporter une nouvelle observation de cholédococèle traité avec succès par sphinctérotomie endoscopique en précisant les avantages et les indications thérapeutiques devant un cholédococèle.

Observation

Il s’agissait d’une patiente de 28 ans investiguée pour douleurs de l’hypochondre droit. La biologie objectivait une discrète cytolyse. L’échographie abdominale montrait une dilatation isolée de la voie biliaire principale sans dilatation des voies biliaires intrahépatiques (VBIH). L’échoendoscopie et le scanner abdominal concluaient à un cholédococèle. La patiente était traitée par sphinctérotomie endoscopique avec incision de la paroi kystique. Les suites furent simples, et la patiente est actuellement asymptomatique. Le traitement endoscopique est une alternative intéressante pour le traitement des cholédococèles permettant d’avoir des résultats comparables à la chirurgie avec moins de morbidité.

Abstract

Introduction

Choledococele is a rare congenital abnormality involving the intramural segment of the common bile duct. Therapeutic modalities were various including surgical and endoscopic treatment.

Aim

The aim of this study is to report a new case of choledococele that was successfully treated by endoscopic sphincterotomy.

Case

A 28-year-old woman, without a significant past medical history, was admitted for right upper quadrant pain. The physical examination was normal. The laboratory examinations showed elevated transaminases level. Abdominal ultrasound showed dilatation of the extrahepatic bile duct at 11 mm without dilatation of intrahepatic biles ducts. Endoscopic ultrasonography and CT scan showed the presence of a choledococele. The patient was treated by endoscopic sphincterotomy. Endoscopic management of choledococele is a very attractive therapeutic option with the advantage of a minimally invasive approach and with a similar result as that of surgery.

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Références

  1. 1.

    Todani T, Watanabe Y, Narusue M, et al (1977) Congenital bile duct cysts: classification, operative procedures, and review of thirty-seven cases including cancer arising from choledochal cyst. Am J Surg 134:263–269

    PubMed  Article  CAS  Google Scholar 

  2. 2.

    Sarris GE, Tsang D (1989) Choledochocele: case report, literature review, and a proposed classification. Surgery 105:408–414

    PubMed  CAS  Google Scholar 

  3. 3.

    Ladas SD, Katsogridakis I, Tassios P, et al (1995) Choledochocele, an overlooked diagnosis: report of 15 cases and review of 56 reports from 1984 to 1992. Endoscopy 27:233–239

    PubMed  Article  CAS  Google Scholar 

  4. 4.

    Kagiyama S, Okazaki K, Yamamoto Y, Yamamoto Y (1987) Anatomic variants of choledochocele and manometric measurements of pressure in the cele and orifice zone. Am J Gastroenterol 82:641–649

    PubMed  CAS  Google Scholar 

  5. 5.

    Akaraviputh T, Boonnuch W, Watanapa P, et al (2005) Surgical management of adult choledochal cysts. J Med Assoc Thai 88:939–943

    PubMed  Google Scholar 

  6. 6.

    Söreide K, Körner H, Havnen J, Söreide JA (2004) Bile duct cysts in adults. Br J Surg 91:1538–1548

    PubMed  Article  Google Scholar 

  7. 7.

    Masetti R, Antinori A, Coppola R, et al (1996) Choledochocele: changing trends in diagnosis and management. Surg Today 26:281–285

    PubMed  Article  CAS  Google Scholar 

  8. 8.

    Dehyle P, Schnaars P, Meyer HJ (1974) Perorale endoskopischelektrochirurgische Abtragung einer Choledochocele. Dtsch Med Wochenschr 99:71–72

    Article  Google Scholar 

  9. 9.

    Gerritsen JJ, Janssens AR, Kroon HM (1988) Choledochocele: treatment by endoscopic sphincterotomy Br J Surg 75:495–496

    PubMed  Article  CAS  Google Scholar 

  10. 10.

    Ghazi A, Slone E (1987) Endoscopic management of choledochocele. A case report and review of the English literature. Surg Endosc 1:151–154

    PubMed  Article  CAS  Google Scholar 

  11. 11.

    Houben CH, Chiu PW, Lau J, et al (2007) Preoperative endoscopic retrograde cholangiopancreatographic treatment of complicated choledochal cysts in children: a retrospective case series. Endoscopy 39:836–839

    PubMed  Article  CAS  Google Scholar 

  12. 12.

    Naga MI, Suleiman DN (2004) Endoscopic management of choledochal cyst. Gastrointest Endosc 59:427–432

    PubMed  Article  Google Scholar 

  13. 13.

    Chatila R, Anderson DK, Topazean M (1999) Endoscopic resection of a choledochocele. Gastrointest Endosc 50:578–580

    PubMed  Article  CAS  Google Scholar 

  14. 14.

    Berger A, Douard R, Landi B, et al (2007) Endoscopic management of a large choledococele associated with choledocholithiasis. Gastroenterol Clin Biol 31:200–203

    PubMed  Article  Google Scholar 

  15. 15.

    Gross E, Koplewitz BZ (2005) Image of the month. Choledochocele type 3 choledochal cyst. Gastroenterology 128:1159, 1536

    PubMed  Article  Google Scholar 

  16. 16.

    Kamisawa T, Yoshiike M, Egawa N, et al (2005) Classification of choledochocele. Hepatogastroenterology 52:29–32

    PubMed  Google Scholar 

  17. 17.

    Ohtsuka T, Inoue K, Ohuchida J, et al (2001) Carcinoma arising in choledochocele. Endoscopy 33:614–619

    PubMed  Article  CAS  Google Scholar 

  18. 18.

    Horaguchi J, Fujita N, Kobayashi G, et al (2005) Clinical study of choledochocele: is it a risk factor for biliary malignancies? J Gastroenterol 40:396–401

    PubMed  Article  Google Scholar 

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Correspondence to O. Baraket.

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Daghfous, A., Baraket, O., Ayadi, S. et al. Cholédococèle traité par sphinctérotomie endoscopique: à propos d’un cas. J Afr Hepato Gastroenterol 5, 111–114 (2011). https://doi.org/10.1007/s12157-011-0264-4

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Mots clés

  • Pathologie biliaire congénitale
  • Kyste du cholédoque
  • Cholédococèle

Keywords

  • Biliary
  • Bile duct cyst
  • Choledochocele