The Curious Case of the Choledochal Cyst—Revisiting the Todani Classification: Case Report and Review of the Literature
Choledochal cysts (CCs) are rare occurrences presenting as dilatations of biliary structures, which can present as single or multiple dilatations and can appear as both intra- and extrahepatic anomalies. The most widespread classification of CCs is the Todani classification, but there have been nume...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-03-01
|
| Series: | Diagnostics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2075-4418/13/6/1059 |
| _version_ | 1827750324109049856 |
|---|---|
| author | Adrian Miron Liliana Gabriela Popa Elena Adelina Toma Valentin Calu Radu Florin Parvuletu Octavian Enciu |
| author_facet | Adrian Miron Liliana Gabriela Popa Elena Adelina Toma Valentin Calu Radu Florin Parvuletu Octavian Enciu |
| author_sort | Adrian Miron |
| collection | DOAJ |
| description | Choledochal cysts (CCs) are rare occurrences presenting as dilatations of biliary structures, which can present as single or multiple dilatations and can appear as both intra- and extrahepatic anomalies. The most widespread classification of CCs is the Todani classification, but there have been numerous reports of cysts that do not fall into any of the types described. We present such a case—a male patient 36 years of age who underwent preoperative CT, MRCP, and ERCP, which mistakenly indicated a type II Todani CC, and intraoperatively was found to be located at the confluence of the hepatic ducts and encompassed the origin of the common bile duct. Complete resection of the cyst and the proximal segment of the common bile duct was performed, and reconstruction was carried out by Roux-en-Y double-tutorized hepaticojejunostomy. Considering the risk of malignant transformation, the frequent preoperative misdiagnosis, as well as the technically challenging surgery required in such cases, we advocate for a revision of the classification and raise awareness of the need for guidelines regarding the proper short-term and long-term management of this disease to ensure adequate quality of life and disease-free survival for patients. |
| first_indexed | 2024-03-11T06:42:11Z |
| format | Article |
| id | doaj.art-ca82c808b2054e218eb6db6ba85bf5ce |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-11T06:42:11Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-ca82c808b2054e218eb6db6ba85bf5ce2023-11-17T10:33:46ZengMDPI AGDiagnostics2075-44182023-03-01136105910.3390/diagnostics13061059The Curious Case of the Choledochal Cyst—Revisiting the Todani Classification: Case Report and Review of the LiteratureAdrian Miron0Liliana Gabriela Popa1Elena Adelina Toma2Valentin Calu3Radu Florin Parvuletu4Octavian Enciu5Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, RomaniaFaculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, RomaniaFaculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, RomaniaFaculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, RomaniaElias Emergency University Hospital, 011461 Bucharest, RomaniaFaculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, RomaniaCholedochal cysts (CCs) are rare occurrences presenting as dilatations of biliary structures, which can present as single or multiple dilatations and can appear as both intra- and extrahepatic anomalies. The most widespread classification of CCs is the Todani classification, but there have been numerous reports of cysts that do not fall into any of the types described. We present such a case—a male patient 36 years of age who underwent preoperative CT, MRCP, and ERCP, which mistakenly indicated a type II Todani CC, and intraoperatively was found to be located at the confluence of the hepatic ducts and encompassed the origin of the common bile duct. Complete resection of the cyst and the proximal segment of the common bile duct was performed, and reconstruction was carried out by Roux-en-Y double-tutorized hepaticojejunostomy. Considering the risk of malignant transformation, the frequent preoperative misdiagnosis, as well as the technically challenging surgery required in such cases, we advocate for a revision of the classification and raise awareness of the need for guidelines regarding the proper short-term and long-term management of this disease to ensure adequate quality of life and disease-free survival for patients.https://www.mdpi.com/2075-4418/13/6/1059choledochal cystsTodani classificationhepaticojejunostomy |
| spellingShingle | Adrian Miron Liliana Gabriela Popa Elena Adelina Toma Valentin Calu Radu Florin Parvuletu Octavian Enciu The Curious Case of the Choledochal Cyst—Revisiting the Todani Classification: Case Report and Review of the Literature Diagnostics choledochal cysts Todani classification hepaticojejunostomy |
| title | The Curious Case of the Choledochal Cyst—Revisiting the Todani Classification: Case Report and Review of the Literature |
| title_full | The Curious Case of the Choledochal Cyst—Revisiting the Todani Classification: Case Report and Review of the Literature |
| title_fullStr | The Curious Case of the Choledochal Cyst—Revisiting the Todani Classification: Case Report and Review of the Literature |
| title_full_unstemmed | The Curious Case of the Choledochal Cyst—Revisiting the Todani Classification: Case Report and Review of the Literature |
| title_short | The Curious Case of the Choledochal Cyst—Revisiting the Todani Classification: Case Report and Review of the Literature |
| title_sort | curious case of the choledochal cyst revisiting the todani classification case report and review of the literature |
| topic | choledochal cysts Todani classification hepaticojejunostomy |
| url | https://www.mdpi.com/2075-4418/13/6/1059 |
| work_keys_str_mv | AT adrianmiron thecuriouscaseofthecholedochalcystrevisitingthetodaniclassificationcasereportandreviewoftheliterature AT lilianagabrielapopa thecuriouscaseofthecholedochalcystrevisitingthetodaniclassificationcasereportandreviewoftheliterature AT elenaadelinatoma thecuriouscaseofthecholedochalcystrevisitingthetodaniclassificationcasereportandreviewoftheliterature AT valentincalu thecuriouscaseofthecholedochalcystrevisitingthetodaniclassificationcasereportandreviewoftheliterature AT raduflorinparvuletu thecuriouscaseofthecholedochalcystrevisitingthetodaniclassificationcasereportandreviewoftheliterature AT octavianenciu thecuriouscaseofthecholedochalcystrevisitingthetodaniclassificationcasereportandreviewoftheliterature AT adrianmiron curiouscaseofthecholedochalcystrevisitingthetodaniclassificationcasereportandreviewoftheliterature AT lilianagabrielapopa curiouscaseofthecholedochalcystrevisitingthetodaniclassificationcasereportandreviewoftheliterature AT elenaadelinatoma curiouscaseofthecholedochalcystrevisitingthetodaniclassificationcasereportandreviewoftheliterature AT valentincalu curiouscaseofthecholedochalcystrevisitingthetodaniclassificationcasereportandreviewoftheliterature AT raduflorinparvuletu curiouscaseofthecholedochalcystrevisitingthetodaniclassificationcasereportandreviewoftheliterature AT octavianenciu curiouscaseofthecholedochalcystrevisitingthetodaniclassificationcasereportandreviewoftheliterature |