Prenatal diagnosis at different gestational times and clinical features of choledochal cysts: A single tertiary center report

Purpose: This study aimed to evaluate the effect of prenatal diagnosis at different gestational times on the clinical features of patients with choledochal cysts (CDCs). Methods Medical records of patients with prenatally diagnosed CDCs admitted to our hospital (April 2013-April 2018) were retrospectively reviewed. The clinical characteristics and pathological CDC features were analyzed. Results Two hundred twenty cases were included. Patients were divided into two groups. Group 1 and group 2 had a prenatal diagnosis at ≤ 27 weeks of gestation (second trimester of gestation, n = 158) and > 27 weeks (third trimester of gestation, n = 62), respectively. The incidence of jaundice and the TBIL, IBIL and GGT levels were higher in Group 1 ( P  = 0.019, P  = 0.029, P  = 0.042, P  = 0.007, respectively). The maximum cyst diameter at the time of surgery was larger in Group 1 ( P  = 0.015). An association study showed that the time of prenatal diagnosis was negatively correlated with the maximum cyst diameter both postnatally ( r =-0.223, P  = 0.001) and at the time of surgery ( r =-0.268, P  < 0.001). Conclusion Unlike patients diagnosed at a late prenatal age, patients diagnosed at an early prenatal age tend to present clinical symptoms (jaundice, manifested as high indirect bilirubin), hepatic function damage, and large cysts at the time of surgery.