What are choledochal cysts?
Choledochal cysts are rare, congenital anomalies of the bile ducts, a network of tubes that carry bile from the liver to the intestines. When choledochal cysts occur in children, these tubes are wider than usual or have abnormal outpouchings in the walls. Although choledochal cysts are rare congenital anomalies, they are more commonly seen in little girls.
What are the symptoms of choledochal cyst formation?
Choledochal cysts in most children are detected on abdominal scans performed for identifying other problems. Children may have non-specific symptoms like vague abdominal pain, poor feeding, fever, or growth failure. At times, especially if there is infection, the child can have jaundice, white stools, and high-grade fever. In rare cases, choledochal cysts may be detected at birth when the newborn baby has a huge swelling in the tummy or has high jaundice.
How are choledochal cysts diagnosed?
Most choledochal cysts are first seen in an ultrasound scan, showing a cyst in the upper part of the tummy. The child then may need to undergo a more detailed imaging of the abdomen in the form of a CT scan, which can confirm whether the swelling is indeed arising from the bile ducts. Before planning the surgery, most surgeons will recommend an MRI of the abdomen in order to see detailed pictures of the choledochal cyst, so as to plan the surgery. Children may also need to undergo supporting scans and blood tests to complete the clinical picture.
What are the problems associated with choledochal cysts?
The presence of choledochal cysts affects the proper flow of bile for the child. This in turn can manifest as recurrent episodes of jaundice in the child. The holdup of bile also increases the chance of infection of the bile ducts, known as cholangitis. Cholangitis is a severe infection that can be life threatening and usually results in hospitalization for the children.
Apart from the above issues, choledochal cysts are also known to increase the chances of cholangiocarcinoma later in life if left untreated. This is an aggressive cancer with poor outcomes.
How are choledochal cysts treated?
The definitive treatment for choledochal cyst occurrence involves removing the cysts totally and ensuring good bile flow from the liver to the small intestine. This is done by completely removing the dilated segment of the bile ducts and making a fresh joining of the stump to the small intestine. This surgery may be done with the help of either laparoscopic (key-hole) or open surgical methods. The optimal approach is decided by the surgeon after completely evaluating the child.
At times the surgery may be delayed so that acute conditions like jaundice and cholangitis are controlled first. This may necessitate admission and IV antibiotics, or an endoscopy for the child.
What is to be expected after surgery in children with choledochal cysts?
Children usually tolerate surgery for choledochal cysts well. Immediately after the surgery, the child may need a couple of days of ICU care so that it can be monitored closely. Once the child recovers, feeding is usually started by the 4th or 5th day. The children are discharged once they start to feed well and the pain comes under control. The surgeon continues to see the child in the OPD to make sure that the wounds are healing well and that the bile drainage is good.
Children undergoing laparoscopic surgeries recover faster than those undergoing open surgeries, although the rate of complications are usually similar.
What is the long-term outcome for children with choledochal cysts?
Children who have undergone surgery for choledochal cysts are usually expected to have a normal life. For the initial few years after surgery, they are monitored so as to ensure that the bile is flowing well and that there is no infection in the bile ducts. Some children might need antibiotics for a certain duration to prevent infection of the biliary tree.
Complete removal of the choledochal cyst reduces the chances of cholangiocarcinoma in children. However, it is prudent to be under regular follow-ups with the surgeon.
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I delivered a baby in 32 weeks, baby was in bit critical stage Dr. Latha, Dr. Vedarth, Dr. Archana and other duty doctors and nurses took care of baby very closely with timely medication too. Also explained in detail of baby health condition as how to progress with her by giving confidence and guidance. Regular monitoring and reviewing health wise helped us a lot in bringing her up.. Thanks to all for the care given to us.
We are from Kerala.My sister was facing some serious health issues that needed a major surgery .But the doctors we consulted in Kerala couldn’t assure about the success of the surgery .At that time we came to know about Dr. Latha of St Philomena’s hospital Bangalore.she was very friendly and gave us confidence.The surgery was successful .Now my sister is feeling better and she is happy. My heart is filled with gratitude . A lot of thanks to Dr.Latha
The most beautiful and worthy to wait moment in one's life is a child's birth. But sometimes complications make it challenging. Despite Dr VEDARTH DASH made it easy for us with our little angel. In a difficult time where things could have gone extremely bad, he gave us a healthy baby after performing a high-risk surgery on our delicate child and taking care of him, for a month, just like a parent and being there for us day or night. Just because he was there in hospital, we were having hope that our child will survive and one day he will come home alive. He is not just one of the most skilled Doctors but also a wonderful human. Today our son is a healthy and growing boy. Jeenath 74062 97888
Hi Doctor, This is father of Sharrvesh Adhyan. We are very grateful to you, as a my son (5 days old) had undergone PUV surgery under your guidance at the right time, we felt he was on the safe hands and we see you as an angel sent through God. Currently he is 7 months old & doing good, we are monitoring him as per your advise and guidance. We will strongly recommend you to all our friends and family. We are always be thankful to you. Your faithfully Vijayakumar 9972988066
Dr. Antony Robert Charles , we met him for our baby boy pediatric surgery related to Hydronephrosis , Dr was very patient and answered all our questions ,concerns he educated and reassured us. Post-surgery follow-ups went very well, it’s been a year now and the scars from the surgery are hardly visible. We would highly recommend him as an excellent pediatric surgeon and great human being. Regards, Madhu