Choledochal cysts surgery in Bangalore & Cost

Dr-Adarsh-M-Patil-3Dr Adarsh M Patil mbbs ms is Consultant GI Surgeon is associated with eminent hospitals like Manipal Hospital, Apollo Hospitals and Narayana Hrudalaya, Columbia Asia in Bangalore.

He has experience of treating choledochal cysts patients successfully .

He believes that patient safety comes first and strives to provide exceptional service to patients.

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Choledochal cysts

  • Choledochal cysts are congenital dilations of the biliary tree.
  • They may occur in any bile duct but characteristically involve the common hepatic duct and common bile duct. They are more frequently identified in women (3:1 ratio) and those of Asian descent.
  • Sixty percent are diagnosed in patients under the age of 10 years.
  • Diagnosis and treatment are essential because the cysts predispose to jaundice, choledocholithiasis, cholangitis, portal hypertension, and cholangiocarcinoma.
choledochal cysts surgery in Bangalore

choledochal cysts surgery in Bangalore

Anatomic classification.

 These are not cystic lesions per se but rather dilations of the bile duct. In addition, the majority of choledochal cysts are associated with an unusually long common channel where the biliary and pancreatic ducts join much higher than usual (“anomalous biliary-pancreatic junction”) for choledochal cysts surgery in Bangalore.

A classification scheme has identified five distinct types.

  • Type I cysts are fusiform dilations of the common bile duct and are by far the most common (65% to 90%).
  • Type II cysts are rare, isolated saccular diverticula of the common bile duct.
  • Type III cysts, also termed choledochoceles, are localized dilations within the intraduodenal part of the common bile duct. Most lesions thought to be choledochoceles are in fact duodenal duplications.
  • Type IV cysts are characterized by multiple cystic areas of the biliary tract, both inside and outside of the liver. Finally,
  • type V cysts are single or multiple lesions based only in the intrahepatic portion of the tract (Caroli disease).for choledochal cysts surgery in Bangalore

Diagnosis 0f choledochal cysts

  • The classic triad of right upper quadrant pain, jaundice, and a palpable abdominal mass is present only a minority of the time. Pain may mimic biliary colic.
  • Neonates frequently present with biliary obstruction, whereas older youths suffer from jaundice and abdominal pain.
  • Rarely, pancreatitis or duodenal obstruction can be caused by a choledochocele.
  • Cirrhosis, sepsis from cholangitis, or free intraperitoneal rupture occur infrequently as late complications for choledochal cysts surgery in Bangalore.

Tests for choledochal cysts

Initial diagnosis is often made with ultrasonography and/or CT scan. An apparent increase in incidence of these lesions has paralleled advances in and use of these modalities. Further evaluation of the cyst should be obtained with specific biliary imaging such as ERCP for choledochal cysts surgery in Bangalore.

Treatment – Choledochal cysts surgery in Bangalore

  • Treatment is primarily surgical, as medical therapies are not successful. Cholangiocarcinoma develops in up to 30% of cysts and usually presents in the fourth decade of life.
  • Cyst excision with a Roux-en-Y hepaticojejunostomy reconstruction is the treatment of choice for types I and IV. Simple excision of the rare type II cyst has been performed.

    Local cyst excision with sphincteroplasty through a transduodenal approach is effective for type III disease.

    Endoscopic excision is now being evaluated.

    Caroli disease can be treated with hemihepatectomy when confined to one side of the intrahepatic tract. More often, bilateral disease is present with associated liver damage and mandates orthotopic liver transplantation for choledochal cysts surgery in Bangalore