Acta Scientific Medical Sciences (ASMS)(ISSN: 2582-0931)

Case Report Volume 8 Issue 6

Choledochal Cyst Type Three Diagnostic and Management Approach

Ali Hassan Abdulla1, Ahmed Jaber2, Rola Mahmood3, Jawad Khamis4 and Yusuf Barhoom5*

1MBBS General Surgery, Senior Resident at Salmaniya Medical Complex, Kingdom of Bahrain
2MBBS General Surgery, Junior Resident at Governmental Hospitals/Salmaniya Medical Complex, Kingdom of Bahrain
3Consultant Radiologist at Governmental Hospitals/Salmaniya Medical Complex, Kingdom of Bahrain
4Gastroenterology and Hepatology Consultant at Governmental Hospitals/Salmaniya Medical Complex Kingdom of Bahrain
5MD, CABS, MSc, MS Transplant, FEBS (Transplantation Surgery), FSSO, FACS General Surgery and HBP Surgeon at Governmental Hospitals/Salmaniya Medical Complex, Kingdom of Bahrain

*Corresponding Author: Yusuf Barhoom, MD, CABS, MSc, MS Transplant, FEBS (Transplantation Surgery), FSSO, FACS General Surgery and HBP Surgeon at Governmental Hospitals/Salmaniya Medical Complex, Kingdom of Bahrain.

Received: April 24, 2024; Published: May 16, 2024

Abstract

Choledochal cysts are biliary tree congenital cysts that could be extrahepatic or intrahepatic and have premalignancy potential depending on their type and pathophysiological consequences. Though usually asymptomatic, patients may present with palpable masses or cholestasis-related symptoms. The therapeutic intervention depends on the cyst type.

We present a rare case of type three, Todani classification, choledochal cyst in a 26-year-old male patient who presented with acute on top of chronic pancreatitis. The aim is to present rare case therapeutic approaches based on the current literature.

Acute obstruction-related cystic dilatation impacts the decision on the best therapeutic approach for such patients, and hepatobiliary surgery experts' elaboration and longer follow-up are needed.

Core Tip: Malignant transformation assessment is an essential element in the type three choledochal cyst management plan, as there is no guideline that facilitates the selection of the best therapeutic intervention.

 Keywords: Choledochal Cysts (CCs); Gallbladder

References

  1. Ten Hove A., et al. “Meta-analysis of risk of developing malignancy in congenital choledochal malformation”. British Journal of Surgery5 (2018): 482-490.
  2. Makin E and Davenport M. “Understanding choledochal malformation”. Archives of Disease Child1 (2012): 69-72.
  3. Dhupar R., et al. “The changing presentation of choledochal cyst disease: an incidental diagnosis”. HPB Surgery 2009 (2009): 103739.
  4. Wu GZ., et al. “Diagnosis and minimally invasive treatment of type III choledochal cysts”. BMC Surgery1 (2022): 272.
  5. Bhavsar MS., et al. “Choledochal cysts : a review of literature”. Saudi Journal of Gastroenterology4 (2012): 230-236.
  6. Gorenstein L., et al. “Etiology of choledochal cysts: two instructive cases”. Canadian Journal of Surgery4 (1985): 363-367.
  7. Ziegler KM., et al. “Choledochoceles: are they choledochal cysts?” Annals of Surgery4 (2010): 683-690.
  8. Ye Y., et al. “Pathogenesis of Choledochal Cyst: Insights from Genomics and Transcriptomics”. Genes (Basel)6 (2022): 1030.
  9. Kaye E., et al. “Choledochocele Presenting as Recurrent Pancreatitis”. Radiology Case Report3 (2015): 174.
  10. Gigot J., et al. “Bile duct cysts: A changing spectrum of disease”. Journal of Hepato-Biliary-Pancreatic Surgery 3 (1996): 405-411.
  11. O'Neill JA Jr. “Choledochal cyst”. Current Problems in Surgery6 (1992): 361-410.
  12. Akinyinka OO., et al. “Choledochal cysts in African infants: a report of 3 cases and a review of the literature”. Tropical Gastroenterology1 (2005): 34-36.
  13. Sikhondze MM., et al. “Giant Choledochal Cyst in an Adult at a Teaching Hospital in South- Western Uganda: A Case Report”. International Medical Case Reports Journal 14 (2021): 789-795.
  14. Baison GN., et al. “Choledochal cysts: Similarities and differences between Asian and Western countries. World Journal of Gastroenterology26 (2019): 3334-3343.
  15. Jang SM., et al. “Clinical comparison of choledochal cysts between children and adults”. Korean Journal of Hepato-Biliary-Pancreatic Surgery 3 (2011): 157-163.
  16. Lobeck IN., et al. “The presentation and management of choledochocele (type III choledochal cyst): A 40-year systematic review of the literature”. Journal of Pediatric Surgery4 (2017): 644-649.
  17. Machado NO., et al. “Choledochal Cyst in Adults: Etiopathogenesis, Presentation, Management, and Outcome-Case Series and Review”. Gastroenterology Research and Practice 2015 (2015): 602591.
  18. Hoilat GJ and John S. “Choledochal Cyst”. 2023 Aug 28. In: StatPearls. Treasure Island (FL): StatPearls Publishing (2023).
  19. Dumitrascu T., et al. “The Todani classification for bile duct cysts: an overview”. Acta Chirurgica Belgica 5 (2012): 340-345.
  20. Miron A., et al. “The Curious Case of the Choledochal Cyst-Revisiting the Todani Classification: Case Report and Review of the Literature”. Diagnostics (Basel)6 (2023): 1059.
  21. Ziegler KM., et al. “Choledochoceles: are they choledochal cysts?” Annals of Surgery4 (2010): 683-690.
  22. Soares KC., et al. “Choledochal cysts: presentation, clinical differentiation, and management”. Journal of the American College of Surgeons 6 (2014): 1167-1180.
  23. Madadi-Sanjani O., et al. “Choledochal Cyst and Malignancy: A Plea for Lifelong Follow-Up”. European Journal of Pediatric Surgery2 (2019): 143-149.
  24. Nicholl M., et al. “Choledochal cysts in western adults: complexities compared to children”. Journal of Gastrointestinal Surgery 3 (2004): 245-252.
  25. Ng DW., et al. “Metachronous cholangiocarcinoma 13 years post resection of choledochal cyst-is long-term follow-up useful?: a case study and review of the literature”. Surgery Case Report1 (2016): 60.
  26. Søreide K and Søreide JA. “Bile duct cyst as precursor to biliary tract cancer”. Annals of Surgical Oncology3 (2007): 1200-1211.
  27. Imazu M., et al. “Factors of biliary carcinogenesis in choledochal cysts”. European Journal of Pediatric Surgery 1 (2001): 24-27.
  28. Søreide K and Søreide JA. “Bile duct cyst as precursor to biliary tract cancer”. Annals of Surgical Oncology 14.3 (2007): 1200-1211.

Citation

Citation: Yusuf Barhoom., et al. “Choledochal Cyst Type Three Diagnostic and Management Approach”.Acta Scientific Medical Sciences 8.5 (2024): 68-73.

Copyright

Copyright: © 2024 Yusuf Barhoom., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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