Long Term Follow up of Hepatic-Duodenum-Anastomosis in Patients with Choledocal Cyst. A Good Alternative for Treatment of Choledocal Cyst
Antonio F. Gallardo Meza, MD, FACS; Raul Villarroel Cruz, MD; Humberto Cantoral Uriza, MD, FACS; Linda Espinosa Jimenez, MD; Maria Teresa Martinez Gonzalez, MD; Maria del Carmen Palacios Zuluetz, MD; Jose Manuel Gonzalez Sanchez, MD; Armando Martinez de l
Contact Us: 1-800-253-7657
Cyst resection with hepatic-enterostomy is the treatment of choice in choledocal cyst. Hepatic-Yeyunal-Anastomosis in Y of Roux is the most used technique. The main objection for hepatic-duodenum-anastomosis (HDA) is the reported high frecuency of ascendent cholangitis, but we think this seems to be unjustified. We want to show our experience with HDA. In 10 patients we made cyst resection and wide terminal-lateral Hepatico-duodenum-anastomosis leaving a T tube in anastomosis site for five days. Eight patients were women and two men. Eight patients had choledocal cyst type I (fusiform)and 2 were type IV A. We did not have trans-operative, neither post-operative complications. The follow up is from 18 months to 14 years, without any event of cholangitis in all this patients. We notice intrahepatic air image in the abdominal X Ray in all cases, without clinical and laboratory. Our results showed that HDA, is still a very good option for the treatment of choledocal cyst. It is easy to perform, with less surgical time and less management of abdominal cavity. Long term follow up showed good clinical evolution, without any cholangitis event.