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Choledochal cysts in pregnancy: Case management and literature review

机译：妊娠期胆总管囊肿：病例管理和文献复习

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AIM: To evaluate the diagnosis, management principles and long-term results of congenital choledochal cysts in pregnancy. METHODS: Three adult patients were diagnosed as choledochal cysts in pregnancy from 1986 to 1989 and their long-term results were evaluated. RESULTS: The first patient had a Roux-en-Y cysto-jejunostomy with T-tube external drainage and died of septic shock and multi-organ failure 25 d after operation. In the second patient, 4 wk after percutaneous trans-choledochal cyst was drained externally with a catheter under US guidance, four weeks later the patient delivered vaginally, and had a cysto-jejunostomy 3 mo after delivery, and lived well without any complications for 15 years after operation. The third patient received Roux-en-Y cysto-jejunostomy after a vertex delivery by induced labor at 28 wk gestation, and demonstrated repetitively intermittent retrograde cholangitis within 10 years, and then died of well-differentiated congenital cholangioadenocarcinoma one month after re-operation with exploratory biopsy at the age of 36. CONCLUSION: More conservative approaches such as external drainage of choledochal cyst should be considered for pregnant patients with high risk, complete excision of choledochal cyst during hepaticojejunostomy or modified hepaticojejunostomy is highly recommended at the optimal time.
机译：目的：评估妊娠期先天性胆总管囊肿的诊断，治疗原则和长期结果。方法：1986年至1989年，三名成年患者在怀孕期间被诊断为胆总管囊肿，并对其长期结果进行了评估。结果：第一例患者接受了Roux-en-Y膀胱空肠吻合术并经T形管外引流，术后25 d因败血性休克和多器官功能衰竭而死亡。在第二例患者中，经US指导下经导管将经皮穿刺胆总管囊肿引流4周后，患者于4周后阴道分娩，并在分娩后3个月进行了空肠空肠造口术，并且生活良好，无任何并发症15手术后的几年。第三例患者在妊娠28周时经引产分娩后接受了Roux-en-Y膀胱空肠吻合术，并在10年内表现出反复间歇性逆行性胆管炎，然后在再次手术后1个月死于高分化先天性胆管腺癌。 36岁时进行探索性活检。结论：对于高危孕妇，应考虑采用保守治疗方法，如胆总管囊肿外部引流，强烈建议在最佳时机进行肝空肠吻合术或完全改良肝空肠吻合术时完全切除胆总管囊肿。

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