TITLE:
Can Mucosectomy be Always Performed in Complicated Cases of Choledochal Cysts
AUTHORS:
Sezen Özkisacik, Mesut Yazici, Canten Tataroglu, Yelda Ozsunar, Harun Gürsoy
KEYWORDS:
Mucosectomy, Choledoch, Cyst
JOURNAL NAME:
Surgical Science,
Vol.2 No.1,
January
28,
2011
ABSTRACT: Introduction: If the surgical dissection is too risky in choledochal cyst, mucosectomy is defined as a beneficial technical method in the literature. To discuss in this manner, we present this case. Case: 9 years old girl was referred to our clinic due to multipl stones in the gallbladder. History and physicial examination could not be performed effectively because of her cerebral palsy. Ultrasonography showed choledochal cyst containing multipl stones. MR cholangiography showed multipl stones in the dilated choledochus. During the dissection, the cyst appeared extremely adherent to the adjacent structures and cyst wall was so thin and transparent. The mucosectomy was not thought to be a good option to carry out for this case. For this reason, cyst was totally excised. Discussion: The preferred method for choledochal cyst is total cyst excision and Roux-en Y hepaticoenterostomy. When the dissection is unsafe to perform, posterior wall mucosectomy may be performed. However, like in our case, when the diagnosis is delayed, the cyst wall may become too thin and may be attached very strongly to the adjacent structures. So, mucosectomy is impossible and full layer total cyst excision remains as the only alternative in spite of its high risks.