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Rosalynn's ABSITE > Choledochal cysts > Flashcards

Choledochal cysts Flashcards

1
Q
A

Type I

Fusiform dilation of EXTRAhepatic bile ducts

Intrahepatic ducts not involved

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2
Q

What choledochal cysts are NOT involved with intrahepatic ducts?

A

Type I, II, III, IVb

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3
Q

What choledocal cysts are involve the intrahepatic ducts only?

A

Type V

Caroli disease

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4
Q

Which choledochal cysts involve only extra-hepatic ducts?

A

Type I, II, III, IVb

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5
Q

What choledocal cyst has one extrahepatic cyst and many intrahepatic cysts?

A

Type IVa

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6
Q

What choledochal cyst has multiple small extrahepatic cysts along with no intrahepatic cysts?

A

Type IVb

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7
Q

Which choledochal cysts involve both intra and extra hepatic ducts?

A

Type IVa

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8
Q
A

type II

diverticulum off the CBD

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9
Q

which choledochal cyst has decreased malignant potential?

A

Type II

diverticulum off the CBD

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10
Q
A

Type IVa

one extrahepatic cyst and many intrahepatic cysts

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11
Q
A

Type III

“choledochocele”

cystic dilation of the CBD within the wall of the duodenum

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12
Q
A

Type IVb

multiple extrahepatic cysts without intrahepatic involvement

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13
Q
A

Type V

“caroli disease”

only intrahepatic cysts

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14
Q

The majority of choledochal cysts are associated with?

A
  • Anomalous pancreaticobiliary junction (APBJ)
  • This anomaly is defined as a long common biliary and pancreatic channel
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15
Q

What is the MC symptom that leads to diagnostic imaging?

A

Jaundice

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16
Q

What is the first diagnostic imaging ordered for choledochal cyst?

A

RUQ U/S

17
Q

What is the ideal imaging for a choledochal cyst?

A

MRCP

Shows detailed anatomy of the biliary and pancreatic ducts

18
Q

If you have choledochal cyst on MRCP or obstructive jaundice what is the next step?

A

ERCP or PTC

to confirm dx and offer intervention

19
Q

What is the intervention for a Type I cyst?

A
  1. Cyst excision
  2. roux en Y hepaticojejunostomy or hepaticoduodenostomy
20
Q

What is the intervention for a Type II cyst?

A

Resect diverticulum off the side of the CBD

21
Q

What is the intervention for a Type III cyst?

A

endoscopic sphincterostomy vs transduodenal excision and sphincteroplasty

22
Q

What is the intervention for a Type IV cyst?

A
  1. cyst excision
  2. Roux en Y hepaticojejunostomy or hepaticoduodenostomy
  3. consider hepatic resection if cysts limited to one lobe
23
Q

Which cysts can be treated with hepaticojejunostomy or hepaticoduodenostomy?

A

Types I and IV

24
Q

What is the intervention for a Type V cyst?

A

liver transplant is needed to treat the whole disease

Rosalynn's ABSITE (33 decks)

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