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Management of Bile Duct Cysts in Adults
Daniel J. Deziel, MD;
Ricardo L. Rossi, MD;
Lawrence Munson, MD;
John W. Braasch, MD;
Mark L. Silverman, MD
Arch Surg. 1986;121(4):410-415.
Abstract
• In 31 adult patients with bile duct cysts seen at the Lahey Clinic (Burlington, Mass) during a 20-year period, the median age at time of initial therapy at Lahey Clinic was 34 years. Abdominal pain was the most common presenting symptom, followed by jaundice and fever. The 31 patients underwent a total of 86 biliary tract procedures, of which 37 were performed at Lahey Clinic. Internal drainage was the most common operation, but it frequently resulted in recurrent symptoms requiring reoperation. Cyst excision was associated with a significantly lower incidence of recurrent cholangitis and need for reoperation and was not associated with increased operative mortality. Cystic disease was frequently associated with other hepatobiliary diseases. Biliary carcinoma occurred in five (16%) of our patients, and late deaths from biliary-related disease occurred in seven patients (22%). When technically possible, cyst excision is the treatment of choice.
(Arch Surg 1986;121:410-415)
Author Affiliations
From the Departments of Surgery (Drs Deziel, Rossi, Munson, and Braasch) and Pathology (Dr Silverman), Lahey Clinic Medical Center, Burlington, Mass. Dr Deziel is now with Rush-Presbyterian—St Luke's Medical Center, Chicago.
Footnotes
Accepted for publication Jan 3, 1986.
Read before the 66th Annual Meeting of the New England Surgical Society, Dixville Notch, NH, Oct 11, 1985.
Reprint requests to Department of Surgery, Lahey Clinic Medical Center, 41 Mall Rd, Burlington, MA 01805 (Dr Rossi).
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