Treatment of the Congenital Biliary Dilatation : The Importance of Early Secondary Excision of the Dilated Common Bile Duct in Cases in Whom the Dilated Common Bile Duct Has Not Been Primarily Excised

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  • Miyano Takeshi
    Department of Pediatric Surgery, Juntendo University, School of Medicine
  • Suruga Keijiro
    Department of Pediatric Surgery, Juntendo University, School of Medicine

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Other Title
  • 先天性胆道拡張症の治療 : 初回総胆管拡張部非切除例に対する早期二次的切除術の重要性
  • センテンセイ タンドウ カクチョウショウ ノ チリョウ ショカイ ソウ タンカ

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Postoperative follow up studies were performed in 55 cases of congenital biliary dilatation who had been operated on at our department. None of postoperative complications was found in 40 cases in whom the cyst had been primarily excised. In contrary, three out of nine cases in whom the cyst had not been primarily excised developed postoperative cholangitis. Furthermore, postoperative cholangitis developed only in those of cystic biliary dilatation and not in those of fusiform dilatation. A hepaticojejunostomy (R-Y) following secondary excision of the dilated common bile duct was performed in nine cases including six who had undergone the first operation some where else. Secondary excision was difficult but dramatically effective except in one case who developed the stricuture of hepaticojejunostomy. These results strongly suggested that primary excision is mandantory in the early stage. If primary excision is impossible, early secondary excision is recommended after a temporary external biliary drainage without internal drainage operation.

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