Prevention and treatment for pancreatic duct injury during the excision of choledochal cyst

Objective To evaluate the management and prevention of pancreatic ductal injury during the excision of choledochal cyst (CC). Methods From 1980 to 1999, 112 children with CC underwent hepaticoduodenostomy after excision of the cyst.The clinical materials of 5 cases with pancreatic duct injury were analyzed retrospectively. Results Of them, 3 cases were performed on primary repair, one case on parcreaticoduodenostomy and one on accessory pancreatic duct ligation. Four of them recovered satisfactorily, one had pancreatic fistula healed up by conservative therapy. Conclusions With the intraoperative cholangiopancreatography (ICP), the entry points of the common bile duct and pancreatic duct, the level of cyst resection must be identified in order to prevent the pancreatic duct injury . A primary repair or reconstruction of the pancreatic duct should be followed in case of injury.