¤Congenital cyst occuring in CBD
¤ manifest by 1 - 2 yrs of age
¤ TODANI classification
type 1 - fusiform dilatation of CBD
type 2- lateral saccular diverticuli of CBD
type 3 - Dilatation of intraduodenal segment of CBD
type4- Dilatation of CBD + intrahepatic biliary dilatation.
type5 multiple intrahepatic cyst
CLINICAL FEATURES -
1. Age - children within 1-2 yrs of age
2. Common in females
3. Abdominal distention due to large cyst & cyst palpated.
4. Slow progressive laundice, recurrent attacks with abdominal pain.
1.USG - confirm presence of abnormal cyst
2. MRI - reveal relation between bile duct & pancreatic duct.
excision of cyst & reconstruction is treatment of choice
Type1- excision of cyst followed by Roux-en-y-hepaticojejunostomy.
Type 2- excision of diverticulum wit suturing of CBD.
Type 3 - endoscopic sphincterntomy is adequate
Type 4- difficult to treat. Treated by Lilly's technique. In this technique posterior wall of byst can be left, after removal of mucosa
1. Recurrent cholangitis wit high grade fever
2. Rupture of cyst
3. CBD stones
4. Carcinoma in cyst