関: choledochal cyst、common bile duct cyst

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/03/09 15:55:39」(JST)

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Choledochal cysts are congenital conditions involving cystic dilatation of bile ducts.^[1] They are uncommon in western countries^[2] but not as rare in East Asian nations like Japan and China.

Signs and symptoms

Most of them present in 1st year of life; adult presentation is rare and usually at this stage is associated with complication . Classic triad of intermittent abdominal pain, jaundice, and a right upper quadrant abdominal mass is found only in minority of patients.

Diagnosis

Direct Hyperbilirubinemia

Types

They were classified into 5 types by Todani in 1977.^[3]

Classification was based on site of the cyst or dilatation. Type I to IV has been subtyped.

Type I: Most common variety (80-90%) involving saccular or fusiform dilatation of a portion or entire common bile duct (CBD) with normal intrahepatic duct.
Type II: Isolated diverticulum protruding from the CBD.
Type III or Choledochocele: Arise from dilatation of duodenal portion of CBD or where pancreatic duct meets.
Type IVa: Characterized by multiple dilatations of the intrahepatic and extrahepatic biliary tree.
Type IVb: Multiple dilatations involving only the extrahepatic bile ducts.
Type V or Caroli's disease: Cystic dilatation of intra hepatic biliary ducts.

Treatment

Choledochal cysts are treated by surgical excision of the cyst with the formation of a roux-en-Y anastomosis to the biliary duct. Future complications include cholangitis and a 2% risk of malignancy, which may develop in any part of the biliary tree.

References

^ "choledochal cyst" at Dorland's Medical Dictionary
^ Liu YB, Wang JW, Devkota KR, et al. (2007). "Congenital choledochal cysts in adults: twenty-five-year experience". Chin. Med. J. 120 (16): 1404–7. PMID 17825168.
^ Todani T, Watanabe Y, Narusue M, Tabuchi K, Okajima K (1977). "Congenital bile duct cysts: Classification, operative procedures, and review of thirty-seven cases including cancer arising from choledochal cyst". Am. J. Surg. 134 (2): 263–9. doi:10.1016/0002-9610(77)90359-2. PMID 889044.

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English Journal

A botryoid rhabdomyosarcoma diagnosed as a choledochal cyst.

Margain-Deslandes L, Gelas T, Bergeron C, Pracros JP, Collardeau-Frachon S, Lachaux A, Mure PY.SourcePediatric Surgery Department, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Claude Bernard University, Lyon, France.
Pediatric blood & cancer.Pediatr Blood Cancer.2013 Dec;60(12):2089-90. doi: 10.1002/pbc.24680. Epub 2013 Jul 5.
PMID 23832499

A New Operative Approach for Type I Choledochal Cysts.

Jin LX, Fields RC, Hawkins WG, Linehan DC, Strasberg SM.SourceWashington University in Saint Louis School of Medicine, St. Louis, MO, USA.
Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract.J Gastrointest Surg.2013 Nov 13. [Epub ahead of print]
To present a novel modification of the surgical technique for open excision of type I choledochal cysts. The treatment of choice for choledochal cyst is surgical excision because such cysts are associated with an increased incidence of cancer. The commonly used operative technique provides poor acce
PMID 24222324

Early experience of laparoscopic choledochal cyst excision in children.

Lee JH, Kim SH, Kim HY, Choi YH, Jung SE, Park KW.SourceDepartment of Pediatric Surgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea.
Journal of the Korean Surgical Society.J Korean Surg Soc.2013 Nov;85(5):225-229. Epub 2013 Oct 25.
PURPOSE: Laparoscopic choledochal cyst excision with Roux-en-Y hepaticojejunostomy (LCE) in children is being attempted more frequently around the world, and although it has been performed in Korea, no publication has been published on it. However, cholangitis and/or pancreatitis are limitations tha
PMID 24266013

Japanese Journal

急性胆管炎を契機に診断されたcholedochoceleの1例

乾山光子,岸本有為,岡野直樹,原精一,宅間健介,三村享彦,伊藤謙,塩沢一恵,渡邉学,大久保陽一郎,渋谷和俊,三上哲夫,五十嵐良典
Progress of Digestive Endoscopy 84(1), 192-193, 2014
… A diagnosis of choledochocele was made. … The major duodenal papilla could not be identified on the EGD because of the ballooned choledochocele filled with contrast medium. … A needle knife precut was made, and the choledochocele subsequently collapsed after the CBD stones were removed. …
NAID 130004985512

嚢腫状に拡張した下部胆管に認められた十二指腸乳頭部癌の1例

藤田祐司,渡邉誠太郎,佐藤高光,加藤真吾,細野邦広,小林規俊,遠藤格,山中正二,窪田賢輔
胆道 27(2), 240-246, 2013
… 認めた．胆管深部挿管は困難でありsuprapapillary incisionを施行した．ERCで胆管末端の嚢腫状拡張を認めた．EUS，IDUSでは胆管末端は12 mm径の嚢腫状の拡張を認め，十二指腸乳頭部に腫瘍の筋層侵潤を認めた．乳頭部生検は腺癌であった．術前画像診断でAbから発生した浸潤癌と診断した．非共通管拡張型のCholedochoceleの合併も示唆された．手術施行されたが開腹時，肝臓に微小結節が多発していたため試験開腹のみとなった． …
NAID 130004545482

胆管癌を合併した choledochocele の1例

福庭暢彦,大廻あゆみ,宮崎慎一
日本消化器内視鏡学会雑誌 = Gastroenterological endoscopy 52(2), 272-273, 2010-02-20
NAID 10026909683

Related Pictures

★リンクテーブル★

リンク元	「common bile duct cyst」

「common bile duct cyst」

Choledochal cysts
	Classification and external resources
	; Different types of choledochal cysts
ICD-10	Q44.4
ICD-9	751.69
DiseasesDB	2527
eMedicine	article/172099 article/366004 article/934267
MeSH	D015529

　　[★]

総胆管嚢胞

関: choledochal cyst、choledochocele

[1] "choledochal cyst" at Dorland's Medical Dictionary

[pmid17825168-2] Liu YB, Wang JW, Devkota KR, et al. (2007). "Congenital choledochal cysts in adults: twenty-five-year experience". Chin. Med. J. 120 (16): 1404–7. PMID 17825168.

[3] Todani T, Watanabe Y, Narusue M, Tabuchi K, Okajima K (1977). "Congenital bile duct cysts: Classification, operative procedures, and review of thirty-seven cases including cancer arising from choledochal cyst". Am. J. Surg. 134 (2): 263–9. doi:10.1016/0002-9610(77)90359-2. PMID 889044.

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案内

choledochocele