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AIM:To evaluate the diagnosis,management principles andlong-term results of congenital choledochal cysts in pregnancy.METHODS:Three adult patients were diagnosed ascholedochal cysts in pregnancy from 1986 to 1989 andtheir long-term results were evaluated.RESULTS:The first patient had a Roux-en-Y cysto-jejunostomy with T-tube external drainage and died of septicshock and multi-organ failure 25 d after operation.In thesecond patient,4 wk after percutaneous trans-choledochalcyst was drained externally with a catheter under USguidance,four weeks later the patient delivered vaginally,and had a cysto-jejunostomy 3 mo after delivery,and livedwell without any complications for 15 years after operation.The third patient received Roux-en-Y cysto-jejunostomy aftera vertex delivery by induced labor at 28 wk gestation,anddemonstrated repetitively intermittent retrograde cholangitiswithin 10 years,and then died of well-differentiatedcongenital cholangioadenocarcinoma one month after re-operation with exploratory biopsy at the age of 36.CONCLUSION:More conservative approaches such asexternal drainage of choledochal cyst should be consideredfor pregnant patients with high risk,complete excision ofcholedochal cyst during hepaticojejunostomy or modifiedhepaticojejunostomy is highly recommended at theoptimal time.
AIM: To evaluate the diagnosis, management principles and long-term results of congenital choledochal cysts in pregnancy. METHODS: Three adult patients were diagnosed ascholedochal cysts in pregnancy from 1986 to 1989 andtheir long-term results were displayed .RESULTS: The first patient had a Roux-en-Y cysto-jejunostomy with T-tube external drainage and died of septicshock and multi-organ failure 25 d after operation. Thesecond patient, 4 wk after percutaneous trans-choledochalcyst was drained externally with a catheter under USguidance, four weeks later the patient delivered vaginally, and had a cysto-jejunostomy 3 mo after delivery, and livedwell without any complications for 15 years after operation. third-patient received Roux-en-Y cysto-jejunostomy aftera vertex delivery by induced labor at 28 wk gestation , and demonstrated demonstrative repetitively intermittent retrograde cholangitiswithin 10 years, and then died of well-differentiatedcongenital cholangioadenocarcinoma one month after re-operation wit h exploratory biopsy at the age of 36. CONCLUSION: More conservative approaches such asexternal drainage of choledochal cyst should be considered for pregnant patients with high risk, complete excision ofcholedochal cyst during hepaticojejunostomy or modifiedhepaticojejunostomy is highly recommended at the optimal time.