Choledochal Cyst In Children

1. Choledochal Cyst InChildren • What is Choledochal Cyst? • Choledochal cyst is a birth defect, characterized by the swelling or cystic transformation of the bileduct. • The liver produces bile to digest food. Bile duct helps in transporting bile from the liver to the gall bladder and smallintestines. • In case of a choledochal cyst, due to the obstruction of drainage, passage of the bile is hampered,thereby • causing pain, indigestion, jaundice. Child can repeated episodes of infection in bile duct characterised by fever, pain and jaundice. Early treatment of this condition, may reduce the risk of liver cirrhosis and bile duct cancer in adulthood. • Choledochal cyst is a rare condition, as it’s presence is seen in only 1 out of 1,00,000-1,50,000 children in the western countries. Girls are 4 times more prone to it thanboys. • Symptoms of CholedochalCyst: • Even though Choledochal cyst is a birth defect, it’s symptoms may appear in infancy or in older children. Condition may be diagnosed on antenatalscan. • Pain sensation in upper right portion of the stomach orbelly • Abdominalmass • Fever • Jaundice • Nausea andVomiting • Causes of CholedochalCyst: • Experts are of the view, that choledochal cysts occur when the junction between the bile duct and pancreatic duct is notnormal. • Bile duct carries bile from the liver, to the duodenum which is the first part of the small intestine. Before joining duodenum it joins pancreatic duct. In case of an abnormality, pancreatic juice may flow backwards, into the bile duct, thereby causing the formation of cysts. Also obstruction at lower end of bile duct can cause this problem. • The different types of Choledochal Cyst and theirlocations: • Choledochal cysts can be intrahepatic, where it occurs in the bile duct inside the liver, or can be extrahepatic (outside theliver). • Following are the 4 different types of Choledochal cysts that are identified by their location

2. Type 1 Choledocal Cyst – This accounts for upto 90% of all choledochal cysts. It is the cyst of the extrahepatic bile duct. • Type 2 Choledochal Cyst – This occurs as an abnormal pouch or a sac opening from theduct • Type 3 Choledocal Cyst – This cyst is found inside the wall of theduodenum • Type 4 Choledocal Cyst – These are cysts that are present on both intrahepatic and extrahepatic bile ducts. • Ultrasound and MRI are required to confirm thediagnosis. • Treatment of Choledochal Cysts with Minimally Invasive Surgery. • The treatment of choledochal cyst is surgical. It requires excision of cyst and joining the small intestine (duodenum or jejunum) with remaining bile duct. • "Less pain, less scarring and faster recovery are some of the benefits of a Minimally Invasive Surgery (MIS)"– • Says Dr. Prashant Jain, the best paediatric surgeon inIndia. • Minimally Invasive Surgery is done through a small incision, using miniaturized surgical tools and cameras or telescopes. • Laparoscopic Surgery is a popular form of Minimally Invasive Surgery (MIS) for the removal of Choledochal Cyst. In this, the surgeon uses small instruments, which are guided by a smalltelescope. • The surgery is performed by the surgeon who manipulates the instruments while watching them on a video screen. • For more information, or for an appointment with Dr. Prashant Jain, Paediatric Laparascopic Surgeon in Delhi, call: (+91)8766350320.