Long-term complications after extrahepatic cyst excision for type IV-A choledochal cysts

Utpal Anand; Aaron George John; Rajeev Nayan Priyadarshi; Ramesh Kumar; Basant Narayan Singh; Kunal Parasar; Bindey Kumar

doi:10.14701/ahbps.23-021

Ann Hepatobiliary Pancreat Surg 2023 Nov;27(4):433-6

Published online November 30, 2023; https://doi.org/10.14701/ahbps.23-021

Utpal Anand¹, Aaron George John¹, Rajeev Nayan Priyadarshi², Ramesh Kumar³, Basant Narayan Singh¹, Kunal Parasar¹, Bindey Kumar⁴

¹Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Patna, India,
²Department of Radiodiagnosis, All India Institute of Medical Sciences, Patna, India,
³Department of Medical Gastroenterology, All India Institute of Medical Sciences, Patna, India,
⁴Department of Pediatric Surgery, All India Institute of Medical Sciences, Patna, India

Correspondence to: Utpal Anand, MS, MCh
Department of Surgical Gastroenterology, All India Institute of Medical Science, Aurangabad Rd, Phulwari Sharif, Patna 801507, India
Tel: +91-9661507725, Fax: +91-612-2451006, E-mail: utpalanand2@gmail.com
ORCID: https://orcid.org/0000-0003-0653-4129

Received February 15, 2023; Revised March 18, 2023; Accepted March 28, 2023.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract: Forty-five adults with type IV-A choledochal cysts (CDC) who underwent extrahepatic cyst excision from January 2013 to December 2021 were followed up for a median interval of 25 months (range, 2 to 10 years) to observe the long-term complications in the remaining intrahepatic cyst. Late complications in varying combinations were seen in 10 patients, which included cholangitis and/or intrahepatic stones in 9 patients, intrahepatic bile duct stenosis with stones in 2 patients, anastomotic stricture in 6 patients, and left lobar atrophy with intrahepatic stones in 3 patients. Out of 6 patients who required re-do hepaticojejunostomy (HJ), three patients had left lobe atrophy with patent HJ anastomosis and a recurrent attack of cholangitis on follow-up at 3, 8, and 10 years. Complications occur frequently after extrahepatic cyst excision for type IV-A CDC and require a long-term follow-up.; Keywords : Choledochal cyst type IV; Complications; Bile duct cysts