Evolution in the treatment of choledochus cyst.

PURPOSE: The aim of this study was to reevaluate the results of the short jejunal interposition (Chicago-Beijing procedure) in the treatment of choledochus cyst and search for the way of further improvement.

METHODS: A retrograde study of some 500 surgical cases was made. The immediate postoperative and 10-year follow-up results of the 3 main procedures used in 3 different time periods were compared. Twenty-five redo cases of the above-mentioned series and another 6 referred from other hospitals were analyzed specially for the main cause of complications.

RESULTS: Ten-year uneventful follow-up occurred in more than 90% of cases after the Chicago-Beijing procedure, which was evidently superior to other 2 kinds of methods. Having solved the problems of the abnormal pancreatico-biliary communication and entero-biliary reflux, it remains the challenge of the anastomosis stricture. Malignancy degeneration disappeared dramatically after total excision of the cyst.

CONCLUSIONS: Chicago-Beijing procedure proved to be the most reliable operation for choledochus cyst in comparison with the other 2 conventional methods in BCH. The prevention of anastomosis stricture should be emphasized for the further improvement of the surgical result.