2020 Volume 56 Issue 2 Pages 188-193
Purpose: Cases of prenatally diagnosed congenital biliary dilatation (CBD) with the symptoms of obstructive jaundice and gastrointestinal obstruction should be treated as soon as possible. However, there is no standard protocol for these symptoms. We report the effect and favorable results of choledocheal cyst enterostomy on prenatally diagnosed CBD in the early period after birth.
Methods: CBD was prenatally diagnosed in five patients from January 2014 to January 2019. The symptoms were found in all the patients after birth; thus, two-stage radical surgery (choledocheal cyst excision and hepaticojejunostomy) was performed after choledocheal cyst enterostomy. We retrospectively reviewed and evaluated the patient background characteristics and surgical results.
Results: All cases were detected by fetal ultrasonography at an average gestational age of 25 weeks. The average gestational age at birth was 38 weeks and 6 days, and the average birth weight was 3,380 g. On the basis of Todani’s classification, three cases were of type Ia and two cases were of type IV-A. All the patients underwent choledocheal cyst enterostomy in the early period after birth. There were no postoperative complications and the patients’ symptoms improved. Two-stage radical surgery was performed in four patients (average age, 11.5 months; average body weight, 8.8 kg). One patient at the time of this writing is waiting for radical surgery.
Conclusions: All the patients showed symptoms in the early period after birth. Thus, we performed cyst enterostomy; after which, the symptoms improved. Two-stage radical surgery was safely performed in four patients and favorable results were obtained. Two-stage radical surgery after choledocheal cyst enterostomy may be considered a choice of treatment for symptomatic patients with prenatally diagnosed CBD.
