CAJ | 학술논문

BACKGROUND:?Choledochal? cysts? are? congenital? cystic?dilatations? of? the? extrahepatic? or? intrahepatic? portion? of? the?biliary?tree.?Complete?excision?of?choledochal?cysts?is?currently?regarded? as? the? gold? standard? treatment,? while? less? extensive?procedures? including? cystoduodenostomy? have? become?obsolete? due? to? the? potential? for? malignant? change? in? the?remnant?cyst.?For?type-1?choledochal?cysts,?which?sometimes?extend?to?the?main?pancreatic?duct?closely,?some?surgeons?may?adopt?a?less?aggressive?approach?in?order?to?avoid?damage?to?the?main?pancreatic?duct?as?such?damage?can?lead?to?serious?consequences.? However,? incomplete? excision? of? choledochal?cysts?may?also?cause?problems. <br> METHOD:?Here?we?report?on?a?reoperation?treating?incomplete?excision?of?a?choledochal?cyst?with?focus?on?the?technical?aspect. RESULTS:?In?the?reoperation,?meticulous?dissection?of?the?liver?hilum?which?had?been?previously?operated?on?was?performed.?The?hepaticojejunostomy?was?left?intact.?With?the?assistance?of?intraoperative?cholangiography,?the?residual?pancreatic?portion?of?the?choledochal?cyst?was?completely?excised.?The?pancreatic?opening? and? the? lower? end? of? the? common? bile? duct? were?reconstructed.?Whipple?operation?was?avoided. <br> CONCLUSION:?Careful? planning? with? the? aid? of? precise?imaging?before?and?during?the?operation?largely?enhanced?the?accuracy?of?the?excision?of?the?choledochal?cyst.