- 作者：Jun Fujishiro ; Kouji Masumoto ; Yasuhisa Urita ; Toko Shinkai ; Chikashi Gotoh
- 关键词：Choledochal cyst ; Acute pancreatitis ; Protein plug
- 刊名：Journal of Pediatric Surgery
- 出版年：2013
- 出版时间：September, 2013
- 年：2013
- 卷：48
- 期：9
- 页码：1897-1902
- 全文大小：189 K
Background/Purpose
The aim of this study is to clarify the clinical features and risk factors of pre- and postoperative pancreatic complications in pediatric choledochal cysts.Methods
A retrospective chart review was carried out on pediatric patients with choledochal cysts who underwent radical operation at our department.
Results
Twenty-one, 24, and 24 patients were classified into the Todani Ia, Ic, and IV-A choledochal cyst, respectively. Preoperative acute pancreatitis and protein plugs were observed in 31 (43.7 % ) and 11 (15.5 % ) patients, respectively. Patients with preoperative pancreatitis were more likely to have fusiform dilatation of choledochal cysts (79.3 % vs. 35.0 % ) and a dilated common channel (53.9 % vs. 23.1 % ) compared to those without preoperative pancreatitis. Compared to patients without preoperative protein plugs, those with protein plugs were more likely to have fusiform dilatation (90.9 % vs. 46.5 % ) and pancreatic divisum with communicating ducts and a dilated ductal system (60.0 % vs. 2.5 % ). Postoperatively, three patients (4.2 % ) experienced acute pancreatitis. One of these and all 3 had protein plugs and preoperative pancreatitis, respectively.
Conclusions
Fusiform-type choledochal cyst is a significant risk factor for preoperative pancreatic complications in choledochal cysts. While postoperative pancreatic complications were relatively rare, preoperative pancreatic complications might be risk factors for postoperative pancreatitis.