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Ultraschall Med 2003; 24(3): 197-201
DOI: 10.1055/s-2003-40061
Kasuistik/Case Report
© Georg Thieme Verlag Stuttgart · New York

Kongenitale zystische Dilatation des Ductus cysticus in Kombination mit einer Anomalie der pankreatikobiliären duktalen Junktion

Congenital Cystic Dilatation of the Cystic Duct Associated with an Anomalous Pancreaticobiliary Ductal JunctionH.  Weiler1 , A.  Grandel1 , P.  Frühmorgen1
  • 1Medizinische Klinik I (Schwerpunkt Gastroenterologie/Hepatologie) Klinikum Ludwigsburg
Further Information

Publication History

eingereicht: 5. September 2001

angenommen: 18. Februar 2002

Publication Date:
20 June 2003 (online)

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Zusammenfassung

Wir berichten über eine zystische Dilatation des Ductus cysticus bei einer 40-jährigen Patientin. Sie hatte seit zwei Jahren nahrungsunabhängige, rechtsseitige Oberbauchschmerzen. In der B-Bildsonographie fand sich eine zystische Formation in unmittelbarer Nachbarschaft zur vergrößerten Gallenblase, zum Ductus hepatocholedochus und zur Pfortader. Durch eine endoskopische retrograde Cholangiographie gelang die Diagnosesicherung der zystischen Dilatation des Ductus cysticus sowie einer Anomalie der pankreatikobiliären duktalen Junktion (APBDJ; common channel). Eine Cholezystektomie mit Exzision des gesamten Ductus cysticus und des Ductus hepatocholedochus sowie Anlage einer Roux-Y-Hepatikojejunostomie ist aufgrund des erhöhten Risikos der Entstehung von Gallenwegs- und Gallenblasenkarzinomen bei Vorliegen einer zystischen Anomalie der Gallenwege sowie einer APBDJ Therapie der Wahl.

Abstract

We report a case of congenital cystic dilatation of the cystic duct detected in a 40-year-old woman. She had intermittent pain in the right upper quadrant of the abdomen independent of the intake of meals for the last two years. In the ultrasound we found a cystic formation in the vicinity of the enlarged gallbladder, the common hepatic duct/common bile duct and the portal vein. The endoscopic retrograde cholangiography confirmed a cystic duct malformation, which was associated with an anomalous pancreaticobiliary ductal junction (APBDJ). A cholecystectomy with excision of the whole cystic duct and common bile duct and Roux-en-Y hepaticojejunostomy is indicated because there is an increased risk of the development of bile duct cancer and gallbladder cancer in the presence of biliary cystic duct anomalies and APBDJ.

Schlüsselwörter

Zystische Dilatation des Ductus cysticus - Anomalie der pankreatikobiliären duktalen Junktion - Endoskopische retrograde Cholangiopankreatikographie - Therapie

Key words

Cystic dilatation of the cystic duct - Anomaly of the pancreaticobiliary junction - Endoscopic retrograde pancreatico-cholangiography - Therapy

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PD Dr. Dr. H. Weiler

Medizinische Klinik I · Schwerpunkt Gastroenterologie/Hepatologie · Klinikum Ludwigsburg

Posiliopostraße 4 middot; 71640 Ludwigsburg

Phone: 07141/996478