| [ Summary ] |
Resection of extrahepatic bile ducts, including choledochal cysts and biliary bypasses has become the standard treatment for congenital choledochal cysts. Preoperative studies on the details of the biliary system and the pancreato-biliary junction, and operative cholangiography and endoscopic examinations are mandatory for prevention of late postoperative complications, such as anastomotic strictures, residual intrahepatic bile duct stenosis, intrahepatic cholelithiasis, intrapancreatic duct stones, or cancer of the biliary tract. Intrahepatic bile duct stricture near the hepatic hilum and intrapancreatic portion of the bile duct, and the pancreato-biliary junction, should be thoroughly examined at the time of surgery. Operative procedures to correct intrahepatic duct stenosis and intrapancreatic bile duct stenosis should be performed, dependent on the patient's status. Roux-Y hepatico-jejunostomy is the preferred method of biliary reconstruction. Postoperative follow ups are also important for early diagnosis of bile duct cancer even after the standard procedures for choledochal cysts. |