Clinical characteristics of choledochal cysts with intrahepatic bile duct dilatations

Background: Whether the dilated intrahepatic bile duct (IHBD) has any effect on prognosis of choledochal cyst (CC) remains controversy. This study aimed to summarize the clinical characteristics and prognosis of CC patients with IHBD dilatation. Methods: : A total of 192 children diagnosed with CC were identified, including 127 without IHBD dilatation (group A) and 65 with IHBD dilatation (group B). A retrospective analysis was performed based on clinical indices, symptoms, and complications of CC patients. Results: : Compared with group A, incidences of jaundice and fever were higher in group B (p=0.01 and 0.033, respectively). Preoperative total bilirubin, direct bilirubin, and indirect bilirubin were also increased in group B than in group A (p=0.0052, 0.0005, and 0.0136, respectively), as were preoperative alanine aminotransferase, aspartate aminotransferase, glutamyl transpeptidase, and total bile acid (p=0.0057, 0.0250, 0.0002, and 0.0242, respectively). The risk of liver fibrosis or cirrhosis and postoperative pancreatitis was significantly increased for group B compared with group A (p=0.012 and 0.003, respectively) and also occurred earlier in group B (p<0.001), among them, dilated IHBDs recovered to normal in 89.23% (7/65) of patients. Conclusion: CC with IHBD dilatation was associated with increased preoperative bilirubin levels, abnormal liver function, and higher incidence of liver fibrosis or cirrhosis. Proactive treatment is recommended for patients with IHBD dilatation.