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1.
Sci Rep ; 10(1): 6752, 2020 04 21.
Artigo em Inglês | MEDLINE | ID: mdl-32317688

RESUMO

Few reports describe oxysterols in healthy children or in children with liver disease. We aimed to determine whether developmental changes in urinary and serum oxysterols occur during childhood, and to assess whether oxysterols might be biomarkers for pediatric liver disease. Healthy children enrolled as subjects (36 and 35 for urine and serum analysis, respectively) included neonates, infants, preschoolers, and school-age children, studied along with 14 healthy adults and 8 children with liver disease. We quantitated 7 oxysterols including 4ß-, 20(S)-, 22(S)-, 22(R)-, 24(S)-, 25-, and 27-hydroxycholesterol using liquid chromatography/electrospray ionization-tandem mass spectrometry. Urinary total oxysterols were significantly greater in neonates than in infants (P < 0.05), preschoolers (P < 0.001), school-age children (P < 0.001), or adults (P < 0.001), declining with age. Serum total oxysterols in neonates were significantly lower than in infants (P < 0.05), preschoolers (P < 0.001), school-age children (P < 0.05), or adults (P < 0.01). Compared with healthy children, total oxysterols and 24(S)-hydroxycholesterol in liver disease were significantly increased in both urine (P < 0.001 and P < 0.001, respectively) and serum (P < 0.001 and P < 0.05, respectively). Oxysterols in liver disease, particularly 24(S)-hydroxycholesterol, were greater in urine than serum. Oxysterols change developmentally and might serve as a biomarker for pediatric liver disease. To our knowledge, this is the first such report.


Assuntos
Atresia Biliar/diagnóstico , Cisto do Colédoco/diagnóstico , Colestase Intra-Hepática/diagnóstico , Hepatite Autoimune/diagnóstico , Falência Hepática Aguda/diagnóstico , Oxisteróis , Adolescente , Adulto , Fatores Etários , Atresia Biliar/sangue , Atresia Biliar/patologia , Atresia Biliar/urina , Biomarcadores/sangue , Biomarcadores/urina , Estudos de Casos e Controles , Criança , Pré-Escolar , Cisto do Colédoco/sangue , Cisto do Colédoco/patologia , Cisto do Colédoco/urina , Colestase Intra-Hepática/sangue , Colestase Intra-Hepática/patologia , Colestase Intra-Hepática/urina , Feminino , Hepatite Autoimune/sangue , Hepatite Autoimune/patologia , Hepatite Autoimune/urina , Humanos , Lactente , Recém-Nascido , Fígado/metabolismo , Fígado/patologia , Falência Hepática Aguda/sangue , Falência Hepática Aguda/patologia , Falência Hepática Aguda/urina , Masculino , Pessoa de Meia-Idade , Oxisteróis/sangue , Oxisteróis/urina , Espectrometria de Massas por Ionização por Electrospray
2.
Clinics (Sao Paulo) ; 75: e1539, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32215454

RESUMO

OBJECTIVE: To identify the best mode for diagnosing and treating the patients with choledochal cysts. METHODS: A retrospective study was performed with medical records of patients diagnosed with choledochal cysts from January 1994 to December 2017. In all cases, the diagnosis was based on ultrasound examination. All the patients underwent cyst resection and were divided in two groups: bile enteric anastomosis in the high portion of the common hepatic duct or in the dilated lower portion. RESULTS: Eighty-one cases were studied. The age of presentation was 4 y 2 mo ± 4 y 1 mo, and the age for the surgical treatment was 5 y 5 mo ± 4 y 6 mo. In 61 cases, US was the only image examination performed. There were 67 cases of Todani type I (82.7%), 13 cases of type IV (16.0%) and one case of type III (1.2%). Nine patients (29.0%) in the first period and 2 patients (4.0%) in the second period presented with postoperative complications (p=0.016). CONCLUSION: In patients with choledochal cysts, US is the only necessary diagnostic imaging. Performing the bile enteric anastomosis in the lower portion of the common hepatic duct is safer and has a lower risk of complications.


Assuntos
Ductos Biliares/diagnóstico por imagem , Procedimentos Cirúrgicos do Sistema Biliar/métodos , Cisto do Colédoco/diagnóstico , Cisto do Colédoco/cirurgia , Criança , Cisto do Colédoco/classificação , Humanos , Complicações Pós-Operatórias , Estudos Retrospectivos , Resultado do Tratamento , Ultrassonografia
3.
Pediatr Surg Int ; 36(5): 643-648, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32219559

RESUMO

OBJECTIVE: To explore the clinical value of enhanced recovery after surgery (ERAS) with laparoscopic choledochal cyst (CDC) excision in children. METHODS: A retrospective review was performed on the clinical data from 33 in-patients whose final diagnosis was CDC. We included 18 patients who underwent the traditional treatment for CDC from April 2017 to October 2017 as the control group and 15 patients who underwent the enhanced recovery protocol (ERP) from November 2017 to May 2018 as the ERAS group. All the patients had received three-dimensional (3D) laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy by the same group of pediatric surgeons. The time of initial water intake, postoperative time to total enteral nutrition (TEN), postoperative hospital stay, total cost in hospital, postoperative complications, and readmission rate within 30 days were analysed. RESULTS: The postoperative time of initial water intake, postoperative time to TEN, postoperative hospital stay, and total cost in hospital were (21.5 ± 2.1) h, (4.3 ± 0.5) days, (5.3 ± 0.6) days, and (35,945.49 ± 6071.46) China Yuan (CNY) in the ERAS group and (44.1 ± 3.5) h, (7.7 ± 2) days, (9.1 ± 2.5) days, and (45,609.08 ± 11,439.80) CNY in the control group, respectively. These values in the ERAS group were significantly lower than those in the control group (p < 0.05). There was no significant difference between the two groups in terms of postoperative complications. No readmission patient within 30 days was encountered in either of the two groups. CONCLUSION: Enhanced recovery protocols can shorten postoperative hospital stay, relieve perioperative discomfort, lighten the financial burden, and result in substantial improvements.


Assuntos
Procedimentos Cirúrgicos do Sistema Biliar/métodos , Cisto do Colédoco/cirurgia , Ducto Colédoco/cirurgia , Recuperação Pós-Cirúrgica Melhorada , Imageamento Tridimensional/métodos , Laparoscopia/métodos , Anastomose Cirúrgica , Cisto do Colédoco/diagnóstico , Ducto Colédoco/diagnóstico por imagem , Feminino , Humanos , Lactente , Tempo de Internação , Masculino , Readmissão do Paciente , Complicações Pós-Operatórias , Estudos Retrospectivos
5.
Pan Afr Med J ; 37: 95, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33425128

RESUMO

Choledochal cysts are rare congenital anomalies of the biliary tract. There are 5 subtypes of choledochal cyst and in adults type 4 is the most common. Choledochal cyst rarely exceeds the size of 6cm in the reported literature. Only a handful of cases of giant choledochal cysts are reported in the literature. Here we report a case of a 33-year-old lady who presented with a huge abdominal mass and on evaluation was found to have a giant choledochal cyst type 4A. The patient underwent excision of the extrahepatic hugely dilated choledochal cyst with cholecystectomy and reconstruction was done by Roux-en-Y hepaticojejunostomy to the confluence of the right and left hepatic duct at the hilum.


Assuntos
Anastomose em-Y de Roux/métodos , Colecistectomia/métodos , Cisto do Colédoco/cirurgia , Adulto , Cisto do Colédoco/diagnóstico , Feminino , Ducto Hepático Comum/cirurgia , Humanos , Jejunostomia/métodos
6.
BJS Open ; 3(6): 785-792, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31832585

RESUMO

Background: Todani type 1 and 4 choledochal cysts are associated with a risk of developing cholangiocarcinoma. Resection is usually recommended, but data for asymptomatic Western adults are sparse. The aim of this study was to investigate diagnostic interpretation and attitudes towards resection of bile ducts for choledochal cysts in this subgroup of patients across northern European centres. Methods: Thirty hepatopancreatobiliary centres were provided with magnetic resonance cholangiopancreatograms and asked to discuss the management of six cases: asymptomatic non-Asian women, aged 30 or 60 years, with variable common bile duct (CBD) dilatations and different risk factors in the setting of a multidisciplinary team (MDT). The Fleiss κ value was calculated to estimate overall inter-rater agreement. Results: For all case scenarios combined, 83·3 and 86·7 per cent recommended resection for a CBD of 20 and 26 mm respectively, compared with 19·4 per cent for a CBD of 13 mm (P < 0·001). For patients aged 30 and 60 years, resection was recommended in 68·5 and 57·8 per cent respectively (P = 0·010). There was a trend towards recommending resection in the presence of a common channel, most pronounced in the 60-year-old patient. High amylase levels in the CBD aspirate led to recommendations to resect, but only for the 13-mm CBD dilatation. There were no differences related to centre size or region. MDT discussion was associated with recommendations to resect. Inter-rater agreement was 73·3 per cent (κ = 0·43, 95 per cent c.i. 0·38 to 0·48). Conclusion: The inter-rater agreement to resect was intermediate, and the recommendation was dependent mainly on the diameter of the CBD dilatation.


Assuntos
Colecistectomia/estatística & dados numéricos , Cisto do Colédoco/cirurgia , Tomada de Decisão Clínica , Ducto Colédoco/diagnóstico por imagem , Cirurgiões/psicologia , Adulto , Fatores Etários , Doenças Assintomáticas/terapia , Neoplasias dos Ductos Biliares/etiologia , Neoplasias dos Ductos Biliares/prevenção & controle , Colangiocarcinoma/etiologia , Colangiocarcinoma/prevenção & controle , Colangiopancreatografia por Ressonância Magnética , Colecistectomia/psicologia , Cisto do Colédoco/complicações , Cisto do Colédoco/diagnóstico , Ducto Colédoco/anormalidades , Ducto Colédoco/cirurgia , Europa (Continente) , Humanos , Pessoa de Meia-Idade , Variações Dependentes do Observador , Cirurgiões/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos
7.
Pan Afr Med J ; 33: 276, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31692842

RESUMO

Cystic malformations of the bile ducts are rare congenital disorders, with an incidence of 1/2000000 live births. Complication including the angiocholitis, chronic pancreatitis, progressive biliary cirrhosis, portal hypertension or gallbladder lithiases can reveal severe disorder. Spontaneous perforation is one of the rare complications described for the first time in 1934 by Weber. We report the case of an 18-month old baby admitted with subocclusive syndrome with biliary peritonitis. Ultrasound was performed showing abdominal effusion with cystic formation communicating with the bile ducts associated with subcapsular effusion of the liver confirmed by a scanner. Treatment was based on peritoneal toilet with redon drain at the level of the perforation and subhepatic drain without cyst excision. The patient was re-admitted 6 months after this incident to be definitively treated.


Assuntos
Cisto do Colédoco/diagnóstico , Peritonite/diagnóstico , Cisto do Colédoco/terapia , Drenagem/métodos , Humanos , Lactente , Masculino , Peritonite/etiologia , Ultrassonografia
8.
Prog. obstet. ginecol. (Ed. impr.) ; 62(5): 472-474, sept.-oct. 2019. ilus
Artigo em Inglês | IBECS | ID: ibc-192130

RESUMO

OBJECTIVE: To improve differential diagnosis of choledochal cyst, a rare pathology but whose prenatal diagnosis improves neonatal prognosis. CASE REPORT: Choledochal cysts are a rare congenital abnormality of biliary ducts that present as an anechoic mass in the right upper quadrant of the abdomen. In sonographic examination, a connection between the cyst and the common bile duct must be observed to confirm this diagnosis. It is more frequently diagnosed in females and in Asian countries. We describe a pregnant woman diagnosed of an intra-abdominal fetal cyst at 17-weeks of gestation. Ultrasound assessment showed a cystic mass separated from the stomach, moving other abdominal organs from its normal location and growing progressively. Postnatal study confirmed a choledochal cyst of 8-centimeters in diameter. Surgical treatment was recommended and post-surgical evolution was favourable. CONCLUSIONS: Prenatal diagnosis of choledochal cyst allowed to intensify controls to check the growth. Early surgical treatment improved neonatal prognosis and reduced the risk of sequelae


OBJETIVO: mejorar el diagnóstico diferencial del quiste de colédoco, una patología rara pero cuyo diagnóstico prenatal mejora el pronóstico neonatal. CASO CLÍNICO: los quistes de colédoco son una anormalidad congénita rara de los conductos biliares que se presentan como anecoicos, una masa en el cuadrante superior derecho del abdomen. En el examen ecográfico hay una conexión entre el quiste y se debe observar el conducto biliar común para confirmar este diagnóstico. Se diagnostica con mayor frecuencia en mujeres y en países asiáticos. Describimos a una mujer embarazada diagnosticada de un quiste fetal intrabdominal a las 17 semanas de gestación. La evaluación por ultrasonido mostró una masa quística separada del estómago, moviendo otros órganos abdominales desde su ubicación normal y creciendo progresivamente. El estudio posnatal confirmó un quiste de colédoco de 8 centímetros de diámetro. Se recomendó tratamiento quirúrgico y la evolución posquirúrgica fue favorable. CONCLUSIONES: el diagnóstico prenatal del quiste de colédoco permitió intensificar los controles para supervisar el crecimiento temprano. El tratamiento quirúrgico mejoró el pronóstico neonatal y redujo el riesgo de secuelas


Assuntos
Humanos , Feminino , Gravidez , Adulto , Doenças Fetais/diagnóstico por imagem , Doenças Fetais/cirurgia , Cisto do Colédoco/diagnóstico , Diagnóstico Pré-Natal , Diagnóstico Diferencial
9.
Fetal Pediatr Pathol ; 38(6): 477-483, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31204550

RESUMO

Introduction: Both cystic biliary atresia and choledochal cyst present as infantile obstructive cholangiopathy. Methods: We detail an infant with congenital biliary dilatation and obstructive cholangiopathy where clinicoradiological features (antenatally imaged subhepatic cyst, early onset jaundice, intrahepatic dilated biliary radicals) suggested a choledochal cyst but operative findings (lack of a distal communication of cyst with duodenum) and histomorphological features (cicatricial collagen and myofibroblastic hyperplasia in the cyst wall; ductal plate malformation, ductular cholestasis and strong expression of CD56 in the liver) were those associated with biliary atresia. Conclusion: The observations support the contention that BA and CC may be interim entities in a continuum of manifestation of the same pathology.


Assuntos
Insuficiência Adrenal/patologia , Atresia Biliar/patologia , Cisto do Colédoco/patologia , Retardo do Crescimento Fetal/patologia , Vesícula Biliar/patologia , Osteocondrodisplasias/patologia , Anormalidades Urogenitais/patologia , Insuficiência Adrenal/diagnóstico , Idoso , Atresia Biliar/diagnóstico , Cisto do Colédoco/diagnóstico , Diagnóstico Diferencial , Feminino , Retardo do Crescimento Fetal/diagnóstico , Humanos , Fígado/patologia , Osteocondrodisplasias/diagnóstico , Anormalidades Urogenitais/diagnóstico
11.
J Med Case Rep ; 13(1): 160, 2019 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-31122272

RESUMO

INTRODUCTION: Duplication cyst of the alimentary tract is a rare congenital anomaly. Duodenal duplication cyst accounts for less than 5% overall. These entities rarely present in adults. They are often mistaken as choledochoceles. Management is most often complete excision, but it is individualized to the particular case. CASE PRESENTATION: A 22-year-old woman was admitted to our hospital with a history of intermittent colicky right hypochondrial pain not relieved by any medications for the past 3 months. Initially, she was given proton pump inhibitors, but her pain was not relieved. Further evaluation was done, and preoperative imaging showed a cyst in the second part of the duodenum. Magnetic resonance imaging revealed it as a choledochocele, but duodenal duplication cyst was kept in the differential diagnosis. Further ultrasound identified it to be a duplication cyst. After failed endotreatment, the patient was successfully managed with partial excision and marsupialization. CONCLUSION: Duodenal duplication cyst is uncommon and rarely diagnosed in adults. Duplications in the duodenum should always be a part of the differential diagnosis, especially in cystic lesions. Ultrasonogram of the cyst might lead to the proper diagnosis. Surgery is the treatment of choice if endotherapy is not successful.


Assuntos
Cisto do Colédoco/diagnóstico , Cisto do Colédoco/cirurgia , Anormalidades do Sistema Digestório/diagnóstico , Anormalidades do Sistema Digestório/cirurgia , Duodenopatias/diagnóstico , Duodenopatias/cirurgia , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Resultado do Tratamento , Adulto Jovem
12.
Pediatr Surg Int ; 35(8): 845-852, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31134322

RESUMO

PURPOSE: To investigate the causes and treatments of early complications involving laparoscopic radical resection of choledochal cyst and summarize the experience. METHODS: Children with choledochal cyst treated by laparoscopy in the Department of Pediatric Surgery, Fujian Provincial Maternity and Children's Hospital, and Guangzhou Women and Children's Medical Centre, from March 2016 to May 2018, were retrospectively analysed. Demographics, causes and treatments of early complications, liver function analysis and ultrasonography were collected. RESULTS: In total, 231 cases were included; 204 were Type I (156 Type Ia and 46 Type Ic) and 27 were Type IV. No mortality was observed, and 224 cases were successfully laparoscopically operated, while 7 cases were converted to open surgery. Fifteen cases of postoperative developed biliary fistula. There were jejunal Roux loop obstruction in 2 cases and multiple intussusception, anastomotic stenosis after hepaticojejunostomy, residual of choledochal cyst and pancreatic fistula in one each. Patients were followed up ranging from 4 months to 48 months (12.6 ± 0.3 months on average). Postoperative ALT, AST, GGT, TBIL and DBIL all returned to normal during this time. Ultrasonography indicated 5 cases of widened Glisson's sheath and 1 case of intrahepatic hyperdense shadow. CONCLUSION: Early complications of laparoscopic radical resection of choledochal cyst can be minimized by properly managing preoperative indications and contraindications, carefully interpreting the magnetic resonance cholangiopancreatography results and accumulating experience by the surgeons.


Assuntos
Procedimentos Cirúrgicos do Sistema Biliar/efeitos adversos , Cisto do Colédoco/cirurgia , Laparoscopia/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Procedimentos Cirúrgicos do Sistema Biliar/métodos , Pré-Escolar , China/epidemiologia , Cisto do Colédoco/diagnóstico , Feminino , Seguimentos , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Complicações Pós-Operatórias/diagnóstico , Estudos Retrospectivos , Fatores de Tempo , Ultrassonografia
14.
Pediatr Surg Int ; 35(3): 273-282, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30406431

RESUMO

Choledochal malformations (CMs) represent a spectrum of relatively rare and complex congenital anomalies, characterized by abnormal dilatation of the biliary tract in the absence of any acute obstruction. Today, almost 20% of CMs can be detected in-utero using maternal ultrasonography. Formal scientometric analysis was used to identify where modern CM research is taking place and perhaps where our attention should be directed in the future. Thus, this article offers a comprehensive review of recent scientific advances relating to CMs including the current understanding of etiology and classification, whilst also discussing key controversies such as risk of malignant transformation and the role of newer modalities of surgical treatment. Although laparoscopic excision of CMs and biliary reconstruction is nowadays feasible and safe, care should be taken before dispensing with standard open techniques, which have minimal complication rates and proven long-term benefit.


Assuntos
Pesquisa Biomédica , Cisto do Colédoco , Ducto Colédoco/anormalidades , Gastroenterologia , Cisto do Colédoco/diagnóstico , Cisto do Colédoco/epidemiologia , Cisto do Colédoco/cirurgia , Saúde Global , Humanos , Incidência , Laparoscopia , Ultrassonografia
15.
Chin Med Sci J ; 33(3): 194-203, 2018 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-30266111

RESUMO

Choledochocele is a congenital abnormality of the biliary system, which characterized by a cystic dilatation of intramural segment of the distal common bile duct. Choledochocele manifests as cystic lesions in the duodenal lumen and resembles duodenal duplication cysts in imaging. We reported a patient with choledochocele. Magnetic resonance cholangiopancreatography showed a thin-walled sac in the duodenal cavity and a fine tubular structure connecting with the end of the common bile duct. Magnetic resonance cholangiopancreatography is a noninvasive and convenient technique in the diagnosis of choledochocele.


Assuntos
Cisto do Colédoco/diagnóstico por imagem , Cisto do Colédoco/diagnóstico , Adulto , Bário , Colangiopancreatografia por Ressonância Magnética , Endoscopia , Humanos , Imagem por Ressonância Magnética , Masculino , Tomografia Computadorizada por Raios X
16.
Pan Afr Med J ; 29: 156, 2018.
Artigo em Francês | MEDLINE | ID: mdl-30050620

RESUMO

Cystic dilation of the bile ducts (CDBD) is a rare disease in which pain is the major symptom. It mainly affects young women. Carcinogenesis is the main risk of this disease. Complete surgical resection is the treatment of choice. TODANI's classification defines five groups of congenital cystic dilatation of the bile ducts. Choledochocele is classi?ed as type III and is defined as an isolated cystic dilation of the ampulla of Vater. Few studies were published in the literature due to its rarity and to its multitude of clinical presentations. The lack of guidelines resulted in approaches to treatment based on endoscopic treatment, making rapid progress but considered as a conservative option, or on hardly obtainable complete surgical resection. This study reports the case of a 32-year old female patient presenting with cyclic epigastric pain. Morpho-clinical examinations showed holedochocele. Complete resection of the cyst via duodenotomy with reimplantation of the common bile duct and of the Wirsung duct associated with cholecystectomy were performed.


Assuntos
Dor Abdominal/etiologia , Colecistectomia/métodos , Cisto do Colédoco/diagnóstico , Adulto , Cisto do Colédoco/cirurgia , Ducto Colédoco/cirurgia , Feminino , Humanos , Ductos Pancreáticos/cirurgia
18.
Br J Surg ; 105(5): 482-490, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29480528

RESUMO

BACKGROUND: Choledochal malformations comprise various congenital cystic dilatations of the extrahepatic and/or intrahepatic biliary tree. Choledochal malformation is generally considered a premalignant condition, but reliable data on the risk of malignancy and optimal surgical treatment are lacking. The objective of this systematic review was to assess the prevalence of malignancy in patients with choledochal malformation and to differentiate between subtypes. In addition, the risk of malignancy following cystic drainage versus complete cyst excision was assessed. METHODS: A systematic review of PubMed and Embase databases was performed in accordance with the PRISMA statement. A meta-analysis of the risk of malignancy following cystic drainage versus complete cyst excision was undertaken in line with MOOSE guidelines. Prevalence of malignancy was defined as the rate of biliary cancer before resection, and malignant transformation as new-onset biliary cancer after surgery. RESULTS: Eighteen observational studies were included, reporting a total of 2904 patients with a median age of 36 years. Of these, 312 in total developed a malignancy (10·7 per cent); the prevalence of malignancy was 7·3 per cent and the rate of malignant transformation was 3·4 per cent. Patients with types I and IV choledochal malformation had an increased risk of malignancy (P = 0·016). Patients who underwent cystic drainage had an increased risk of developing biliary malignancy compared with those who had complete cyst excision, with an odds ratio of 3·97 (95 per cent c.i. 2·40 to 6·55). CONCLUSION: The risk of developing malignancy among patients with choledochal malformation was almost 11 per cent. The malignancy risk following cystic drainage surgery was four times higher than that after complete cyst excision. Complete surgical resection is recommended in patients with choledochal malformation.


Assuntos
Neoplasias do Sistema Biliar , Cisto do Colédoco , Ducto Colédoco/anormalidades , Neoplasias do Sistema Biliar/diagnóstico , Neoplasias do Sistema Biliar/epidemiologia , Neoplasias do Sistema Biliar/etiologia , Cisto do Colédoco/complicações , Cisto do Colédoco/diagnóstico , Cisto do Colédoco/cirurgia , Saúde Global , Humanos , Incidência , Fatores de Risco
19.
Kathmandu Univ Med J (KUMJ) ; 16(64): 354-358, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-31729354

RESUMO

Choledochal cyst of the cystic duct is an uncommon entity which may occur as isolated disease or may be associated with choledochal cyst of the other part of the biliary tree. In most of the reported series it was diagnosed at time of operation but now days to better investigation modality it can be diagnosed preoperatively if the index of suspicion is high. We are presenting a series of such case in pediatric age group (which includes an infant) where the diagnosis was made during operation with a light on means and ways for suspecting this entity before operation and how to differentiate other lesion with this entity with relevant review of literature.


Assuntos
Cisto do Colédoco/diagnóstico , Ducto Cístico/diagnóstico por imagem , Adolescente , Colangiopancreatografia por Ressonância Magnética , Diagnóstico Diferencial , Humanos , Masculino , Doenças Raras , Ultrassonografia
20.
Ann R Coll Surg Engl ; 100(2): e34-e37, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29181996

RESUMO

Isolated choledochal cysts involving the cystic duct are rare. We present a case of a choledochal cyst involving only the proximal cystic duct, and discuss the taxonomic and therapeutic challenges. There is a need for a clearly defined classification system for these cysts as they may be categorised as either type II or type VI cysts. The optimal treatment remains debatable, with some authors recommending a bilioenteric reconstruction owing to the wide cystic duct-bile duct junction. However, we suggest that a cholecystectomy should be performed with examination of the specimen and frozen section in case of any abnormality rather than upfront bile duct excision. In addition, given the rarity of this condition and the paucity of long-term data, we recommend meticulous follow-up for development of any malignancy.


Assuntos
Cisto do Colédoco , Ducto Cístico , Adulto , Colecistectomia , Cisto do Colédoco/diagnóstico , Cisto do Colédoco/patologia , Cisto do Colédoco/cirurgia , Ducto Cístico/patologia , Ducto Cístico/cirurgia , Feminino , Humanos
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