Congenital cystic dilatation of the biliary tract main is a rare malformation in adults. Through the retrospective analysis of 9 observations of cystic dilatation of the common bile duct, collected two visceral surgery services A and B of the CHU Hassan II of Fez for four years (January 2009 – December 2012), discussed the epidemiological data, the pathogenesis, classification, diagnosis and treatment. Patients in our study were an average age of 48 years [19-80 years], with a predominantly female sex ratio of 3, 5 (7F / 2 H). The clinical symptomatology was usually a pain right hypochondrium (5 patients), with three patients had an array of cholangitis, the discovery was fortuitous for a single patient during imaging of control of severe acute pancreatitis. Ultrasound and MRI bili allowed the diagnosis in the majority of cases, specifying the type of cystic dilation according to Todani classification, of which there was a predominance of type Ic (3 cases) and IVa (6 cases). Surgical treatment consisted of a total resection of the cyst with hepatico-jejunal anastomosis on a loop in Y for six patients and a choledocho-duodenal junction without surgical resection in a patient, endoscopic sphincterotomy with establishment of a drain has been practiced in two patients. The immediate postoperative were characterized by the occurrence of two patients biliary fistula and infection of the wall in two other patients. The long-term follow-up was in favour with the exception of the death of a patient. Cystic dilatation of the common bile duct is a rare malformation in adults, which is characterized by its female and especially its asymptomatic nature for many years. Congenital cystic dilatation of the biliary tract main is a rare malformation in adults. Through the retrospective analysis of 9 observations of cystic dilatation of the common bile duct, collected two visceral surgery services A and B of the CHU Hassan II of Fez for four years (January 2009 – December 2012), discussed the epidemiological data, the pathogenesis, classification, diagnosis and treatment. Patients in our study were an average age of 48 years [19-80 years], with a predominantly female sex ratio of 3, 5 (7F / 2 H). The clinical symptomatology was usually a pain right hypochondrium (5 patients), with three patients had an array of cholangitis, the discovery was fortuitous for a single patient during imaging of control of severe acute pancreatitis. Ultrasound and MRI bili allowed the diagnosis in the majority of cases, specifying the type of cystic dilation according to Todani classification, of which there was a predominance of type Ic (3 cases) and IVa (6 cases). Surgical treatment consisted of a total resection of the cyst with hepatico-jejunal anastomosis on a loop in Y for six patients and a choledocho-duodenal junction without surgical resection in a patient, endoscopic sphincterotomy with establishment of a drain has been practiced in two patients. The immediate postoperative were characterized by the occurrence of two patients biliary fistula and infection of the wall in two other patients. The long-term follow-up was in favour with the exception of the death of a patient. Cystic dilatation of the common bile duct is a rare malformation in adults, which is characterized by its female and especially its asymptomatic nature for many years.
| Référence | 1173 |
| Année | 2014 |
| Type | Thèse |
| Lien document | |
| Auteur | Driy F |
| Discipline | Chirurgie viscérale B |
| Encadrant | Ibn majdoub hassani K |
