Treatment of XXXX by excision.

@entity1 @entity788 @entity1087 @entity2941 @entity1157 @entity1126 @entity253 @entity255 @entity130
Since 1969 excision of @entity2941 and establishment of bile drainage by Roux-en-Y hepaticojejunostomy has been performed in 7 @entity1 whose ages ranged from 10 mo to 11 yr. In 3 @entity1 , the cyst had been treated 5 yr, 4 wk, and 3 wk previously by cystduodenostomy, cystjejunostomy, and cholecystduodenostomy, respectively; further surgery was indicated for @entity253 and severe @entity255 . The other four @entity1 were not acutely ill. All cysts were located distal to the confluence of the right and left hepatic ducts. The volume of the smallest cyst was 25 ml and the largest 500 ml. In all @entity1 a small remnant of distal cyst was not excised to avoid @entity130 and @entity788 . In four @entity1 a remnant of proximal cyst was left attached to the hepatic duct to allow a large biliary intestinal anastomosis and minimize the possibility of stricture. No serious intraoperative problems were encountered. Prolonged drainage (2-3 wk) from Penrose drain sites in two @entity1 were the only postoperative complications. Liver function tests have remained normal in all and no episodes of @entity255 or @entity1087 have been noted during follow-up (median: 4.5 yr). This experience supports recent reports that indicate that cyst excision is associated with low mortality and morbidity. Cyst excision is preferred over traditional internal drainage procedures because it (A) eliminates a reservoir for @entity1157 , (B) removes a mechanism which allows continuous reflux of pancreatic juice into the cyst, and (C) probably prevents the occurrence of @entity1126 which has been noted in 3.0% of @entity1 with @entity2941 .
