Congenital choledochal cyst with pancreatitis

Objective To understand the relationship among congenital choledochal c yst, anomalous junction of pancreaticobiliary duct (AJPBD) and pancreatitis Methods 25 children with choledochal cyst treated in our hospital were included in this study Their ages ranged from 2 months to 14 years Intraoperative cho la ngiography was performed in 24 children Pancreatic samples obtained from the h e ad and body of the pancreas at operation were observed under light and electron microscope Serum amylase was analyzed one week before and after operation resp e ctively Bile amylase in the cyst and gallbladder was measured at operation Results The incidence of AJPBD was 70%. Inflammatory cell infiltration and fibro us hyperplasia were seen in the pancreatic specimens of 5 children, of whom 4 ha d AJPBD No ultrastructural changes were found in 2 children without AJPBD, whi l e different changes were seen in 6 with AJPBD, including those showing no pathol ogical changes under light microscope All the changes became more severe as th e age of the patient increased The bile and serum amylase levels were higher in children with AJPBD than those without AJPBD ( P <005) Conclusion Congenital choledochal cyst has a close relationship with AJ PBD and pancreatitis Pancreatic pathological changes have a long and chronic c o urse from ultrastructural changes to macroscopic changes for the developing of p ancreatitis