What are the different types of choledochal cysts?
Choledochal cysts are typically diagnosed as one of several types:
- Type I: Cyst of the bile duct.
- Type II: Pouching or sac on the bile duct.
- Type III: Cyst within the wall of the duodenum (where the duct connects to the liver) or pancreas.
- Type IV: A Type I cyst that extends into the liver along the bile ducts.
What is Type 4 choledochal cyst?
Background/purpose: Type IV-A choledochal cysts are characterized by congenital cystic dilatation of the biliary tree extending to involve the intrahepatic biliary channels also. A single-center experience of the management of type IV-A choledochal cysts is presented.
What is Type 3 choledochal cyst?
Type III Cyst Choledochoceles are the true cyst of the distal common bile duct protruding into duodenum. Patients present with biliary colic, cholangitis, or pancreatitis. Until recently transduodenal cyst excision with or without sphincterotomy was the treatment of choice [44].
What is a Type 2 choledochal cyst?
Type II choledochal cysts (see image below) appear as an isolated true diverticulum protruding from the wall of the common bile duct. The cyst may be joined to the common bile duct by a narrow stalk.
What is the management of type II choledochal cyst?
The treatment of choice for choledochal cysts is complete excision. Patients with type I, II, or IV cysts are recommended for surgical excision due to the risk of malignancy, if they are deemed good surgical candidates.
What is a Type 1 choledochal cyst?
Types and locations of choledochal cysts Type 1 — a cyst of the extrahepatic bile duct, accounting for up to 90% of all choledochal cysts. Type 2 — an abnormal pouch or sac opening from the duct. Type 3 — a cyst inside the wall of the duodenum. Type 4 — cysts on both the intrahepatic and extrahepatic bile ducts.
What is the most common type of choledochal cyst?
Type I cysts (see image below) are the most common and represent 80-90% of choledochal cysts. They consist of saccular or fusiform dilatations of the common bile duct, which involve either a segment of the duct or the entire duct. They do not involve the intrahepatic bile ducts.
What is Type 1 choledochal cyst?
Type I cysts are a dilatation of the extrahepatic bile duct. They are the most common type and seen in 75–85% of cases [7, 8]. Type I cysts may be further classified as cystic (IA), focal (IB) or fusiform (IC). The type II cyst is diverticulum of the common bile duct.
Which type of choledochal cyst has highest risk of malignancy?
Patients with types I and IV choledochal malformation had an increased risk of malignancy (P = 0·016). Patients who underwent cystic drainage had an increased risk of developing biliary malignancy compared with those who had complete cyst excision, with an odds ratio of 3·97 (95 per cent c.i. 2·40 to 6·55).
Are choledochal cysts cancerous?
Choledochal cyst is a premalignant condition with substantial risk of malignant transformation into cholangiocarcinoma, bile duct cancer. Cholangiocarcinoma is a type of highly aggressive cancer with a poor prognosis. Diagnosis of choledochal cyst is obtained with CT scan or MRI/MRCP scan.
What is between Triad and Pentad?
Reynolds pentad is a collection of signs and symptoms suggesting the diagnosis obstructive ascending cholangitis, a serious infection of the biliary system. It is a combination of Charcot’s triad (right upper quadrant pain, jaundice, and fever) with shock (low blood pressure, tachycardia) and an altered mental status.