Radical Operation with Hepaticoplasty for Congenital Dilatation of the Bile Duct Associated with Pancreaticobiliary Maljunction

Abstract

Congenital dilatation of the bile duct (CDBD), also referred to as choledochal cyst, is mostly associated with pancreaticobiliary maljunction (PBM). Although previously CDBD was thought to be exclusively a childhood disease, recently it has been recognized to be present in both pediatric and adult populations. In adult patients, complicated clinical presentations and coexistent hepato-biliary-pancreatic diseases are encountered more frequently.¹ Although radical excision of the cy stically dilated bile duct with reconstruction by end-to-side Roux-en-Y hepaticojejunostomy is performed as the standard procedure, it is often difficult in adult patients who have a history of long-lasting inflammation of the bile duct.² In addition, biliary reconstruction for patients with intrahepatic biliary dilatation often leads to postoperative complications.³ In cases in whom the biliary stenosis is located at the orifice of the right or left hepatic ducts, resection from the hepatic hilus is required.⁴ We performed a radical operation with hepaticoplasty of the hepatic duct at the hilum for CDBD associated with PBM and the patient had a good prognosis.