[ XXXX of the biliary system in adults].

@entity1 @entity3123 @entity1087 @entity66 @entity1575 @entity5 @entity3885 @entity29949 @entity255 @entity3116 @entity158 @entity1086 @entity13550 @entity1125
@entity66 of the biliary system is a complex syndrome of ectasies of the intra-, extra- or both situation of biliary tree. This disease has an unsure etiopathogeny. It is uncommon through the third age, with a greater incidence in @entity1 , teen-ager and young adult. The goal of our study is to evaluate the symptoms, diagnosis, treatment and histological aspects of the congenital @entity1125 . We performed a retrospective study from March 1988 to July 2003 about 11 @entity1 with this disease treated in our surgical clinic. Clinical features, methods of diagnosis and surgical treatment were assessed. All @entity1 were females with mean age 51 years (extreme 26-77 years). The symptoms were: right upper @entity158 --11 cases (100%), @entity1087 --6 cases (54.5%), fever--3 cases (27%), palpable abdominal mass--2 cases (18%), weight loss--1 case (9%). The imaging diagnosis was helpful (ultrasonography, CT, ERCP, percutaneous cholangiography and preoperative cholangiography). In concordance with Todani classification the @entity1 were included in the following types: @entity29949 cases (27%), I b--1 case (9%), I c--3 cases (27%), IV a--2 cases (18%), IV b--1 case (9%), V--1 case (9%). All @entity1 were operated on: after cholecystectomy and transcystic cholangiography (11 cases--100%) we performed the total excision of the cyst--9 cases (82%) with choledochal jejunostomy (Roux-en-Y)--6 cases (54.5%), choledochal jejunostomy (omega)--1 case (9%) and choledochal duodenostomy--2 cases (18%). In one case of neoplasic cyst with portal invasion we performed a cyst-jejunostomy (omega) and in one case of @entity13550 with @entity3885 , the solution of choice was choledocal-duodenostomy. The microscopic pathology of the cyst wall showed: chronic intramural inflammation--9 cases (82%) and the absence of the nervous intramural terminations--1 case (9%). The additional lesions was: hepatic cirrhosis--1 case (9%) and @entity1575 --3 cases (27%). We found three cases with @entity5 : malign cyst with advanced local invasion--1 case (9%), @entity3123 --1 case (9%) and @entity1086 (microscopic finding)--1 case (9%). The postoperative morbidity includes @entity3116 --2 cases (18%) and wound infection--2 cases (18%). Long-term follow-up revealed @entity255 in one case--9%. The cystic dilatations of the common bile duct is an exclusive indication for surgery as soon as it was discovered.
