Endoscopic treatment of choledochal cyst type III

ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)

Matheus Alessi Rodrigues¹  Alexandre Venâncio De Sousa¹  Ciro Falcone¹  Gabriel Coelho¹  Durval Knox Da Veiga¹  Mário Zaidan¹  Francisco Callejas-neto¹  Roberto Franchi Teixeira¹ 

关键词: Choledochal cyst;    Endoscopy;    Cisto de colédoco;    Endoscopia;   

DOI  :  10.1590/S0102-67202008000300010

来源: SciELO

【 摘 要 】

BACKGROUND: Todani type III cysts are not very common disease. Endoscopically the choledochocele is not a challenging diagnosis. Sometimes biliary stone disease is associated and events of cholangitis and pancreatitis may occur. Normally these patients are referred for surgical treatment, mainly because there is a widespread concept that choledocal cysts are very prone to develop neoplasia and must be resected. Nevertheless surgical resection is not free of morbidity. The chance for neoplasia in such cases seems to be related to the presence of pancreaticobiliary reflux towards the common bile duct. AIM: To report a case of endoscopic treatment of choledochal cyst type III with literature review. CASE REPORT: Young man with recurrent abdominal pain, fever and hyperamylasemia. An ERCP showed pancreaticobiliary maljunction and calculus impaction. Papillotomy was performed and complete biliary clearance was achieved. Amylase contents in the common bile duct was measured and normal. Due to absence of pancreatiobiliary reflux, a second endoscopic approach was performed and a wide communication between choledochocele and duodenum was done with diathermy (using the papillotome). The patient recovering was uneventful and in 30 months follow-up he remains asymptomatic. CONCLUSION: Since pancreatobiliary reflux is not present, surgical approach of the diverticulum seemed to be not necessary. Endoscopic drainage of choledococele was a good option for conservative treatment.

【 授权许可】

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