The different clinical and liver pathological characteristics between the newborns and infants with choledochal cysts

Background: This study was undertaken to investigate the different clinical presentations of newborns and older infants with choledochal cysts, and their liver pathological changes. Methods: The medical records of patients who were diagnosed with choledochal cysts younger than 1 year old at our hospital from March 1991 through November 2006 were reviewed. Patients were divided into two groups: the newborn group, who presented before 1 month old including those antenatally diagnosed patients; and the infant group, who presented at 1 month to 12 months old. All of the patients' clinical data, including the operative, pathological reports and outcomes were studied and analyzed using the Chi-square and student-t tests. Results: There were 35 patients included in the study. According to the Todani's classification, 74.2% of choledochal cysts were type I. Using Chi-square and student-t tests, the infant group had significantly higher pre-operative morbidity, abnormal levels of serum transaminase, gamma trans-peptide (γ-GT), and grade of liver fibrosis (< grade 2) (p < 0.05). The post operative complications were not statistically significant between newborn and infant groups. Conclusion: Both groups had favorable outcomes after surgical intervention. We suggest that surgical treatment in infants should be performed as early as possible to prevent the progression of liver fibrosis.