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Endoscopic biliary drainage as a bridging procedure to single-stage surgery for perforated choledochal cyst: a case report and review of the literature

Choledochal cyst (CC)—a congenital anomaly of the bile duct—is rare. We report a 28-year-old woman complaining of epigastralgia who was transferred to our hospital. Physical examination revealed severe tenderness to abdominal palpation without symptoms of diffuse peritonitis. Urgent contrast-enhance...

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Autores principales: Minagawa, Takuya, Dowaki, Shoichi, Kikunaga, Hiroyuki, Fujita, Koji, Ishikawa, Keiichi, Mori, Katsuaki, Sakuragawa, Tadayuki, Ichisaka, Shunsuke, Miura, Hiroshi, Kumai, Koichiro, Mikami, Shuji, Kitagawa, Yuko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648837/
https://www.ncbi.nlm.nih.gov/pubmed/26943441
http://dx.doi.org/10.1186/s40792-015-0115-4
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author Minagawa, Takuya
Dowaki, Shoichi
Kikunaga, Hiroyuki
Fujita, Koji
Ishikawa, Keiichi
Mori, Katsuaki
Sakuragawa, Tadayuki
Ichisaka, Shunsuke
Miura, Hiroshi
Kumai, Koichiro
Mikami, Shuji
Kitagawa, Yuko
author_facet Minagawa, Takuya
Dowaki, Shoichi
Kikunaga, Hiroyuki
Fujita, Koji
Ishikawa, Keiichi
Mori, Katsuaki
Sakuragawa, Tadayuki
Ichisaka, Shunsuke
Miura, Hiroshi
Kumai, Koichiro
Mikami, Shuji
Kitagawa, Yuko
author_sort Minagawa, Takuya
collection PubMed
description Choledochal cyst (CC)—a congenital anomaly of the bile duct—is rare. We report a 28-year-old woman complaining of epigastralgia who was transferred to our hospital. Physical examination revealed severe tenderness to abdominal palpation without symptoms of diffuse peritonitis. Urgent contrast-enhanced abdominal computed tomography indicated the dilated common bile duct (CBD) was perforated, with a presumed diagnosis of perforated CC. Endoscopic external biliary drainage was performed immediately as a bridging procedure to the definitive surgery. Additional evaluations confirmed a type IVa CC, according to Todani’s classification, but no signs of malignancy. Twenty-two days after biliary drainage, laparotomy was performed. A large cystic mass was found in the CBD with a perforated scar on the right-side wall. Because inflammation around the pancreas head was too severe to perform cyst excision safely, the patient underwent subtotal stomach-preserving pancreatoduodenectomy. The postoperative course was uneventful, and the patient was discharged on the 29th postoperative day. Pathologic examination of a specimen showed no malignancy, and the patient has remained well during the 3-year follow-up. Our experience with this case suggests that definitive single-stage surgery for perforated CC in an adult can be performed safely owing to external biliary drainage as a bridging procedure, if manifestation of diffuse peritonitis is not evident.
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spelling pubmed-46488372015-11-25 Endoscopic biliary drainage as a bridging procedure to single-stage surgery for perforated choledochal cyst: a case report and review of the literature Minagawa, Takuya Dowaki, Shoichi Kikunaga, Hiroyuki Fujita, Koji Ishikawa, Keiichi Mori, Katsuaki Sakuragawa, Tadayuki Ichisaka, Shunsuke Miura, Hiroshi Kumai, Koichiro Mikami, Shuji Kitagawa, Yuko Surg Case Rep Case Report Choledochal cyst (CC)—a congenital anomaly of the bile duct—is rare. We report a 28-year-old woman complaining of epigastralgia who was transferred to our hospital. Physical examination revealed severe tenderness to abdominal palpation without symptoms of diffuse peritonitis. Urgent contrast-enhanced abdominal computed tomography indicated the dilated common bile duct (CBD) was perforated, with a presumed diagnosis of perforated CC. Endoscopic external biliary drainage was performed immediately as a bridging procedure to the definitive surgery. Additional evaluations confirmed a type IVa CC, according to Todani’s classification, but no signs of malignancy. Twenty-two days after biliary drainage, laparotomy was performed. A large cystic mass was found in the CBD with a perforated scar on the right-side wall. Because inflammation around the pancreas head was too severe to perform cyst excision safely, the patient underwent subtotal stomach-preserving pancreatoduodenectomy. The postoperative course was uneventful, and the patient was discharged on the 29th postoperative day. Pathologic examination of a specimen showed no malignancy, and the patient has remained well during the 3-year follow-up. Our experience with this case suggests that definitive single-stage surgery for perforated CC in an adult can be performed safely owing to external biliary drainage as a bridging procedure, if manifestation of diffuse peritonitis is not evident. Springer Berlin Heidelberg 2015-11-17 /pmc/articles/PMC4648837/ /pubmed/26943441 http://dx.doi.org/10.1186/s40792-015-0115-4 Text en © Minagawa et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Case Report
Minagawa, Takuya
Dowaki, Shoichi
Kikunaga, Hiroyuki
Fujita, Koji
Ishikawa, Keiichi
Mori, Katsuaki
Sakuragawa, Tadayuki
Ichisaka, Shunsuke
Miura, Hiroshi
Kumai, Koichiro
Mikami, Shuji
Kitagawa, Yuko
Endoscopic biliary drainage as a bridging procedure to single-stage surgery for perforated choledochal cyst: a case report and review of the literature
title Endoscopic biliary drainage as a bridging procedure to single-stage surgery for perforated choledochal cyst: a case report and review of the literature
title_full Endoscopic biliary drainage as a bridging procedure to single-stage surgery for perforated choledochal cyst: a case report and review of the literature
title_fullStr Endoscopic biliary drainage as a bridging procedure to single-stage surgery for perforated choledochal cyst: a case report and review of the literature
title_full_unstemmed Endoscopic biliary drainage as a bridging procedure to single-stage surgery for perforated choledochal cyst: a case report and review of the literature
title_short Endoscopic biliary drainage as a bridging procedure to single-stage surgery for perforated choledochal cyst: a case report and review of the literature
title_sort endoscopic biliary drainage as a bridging procedure to single-stage surgery for perforated choledochal cyst: a case report and review of the literature
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648837/
https://www.ncbi.nlm.nih.gov/pubmed/26943441
http://dx.doi.org/10.1186/s40792-015-0115-4
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