What is the role of medications in the treatment of choledochal cysts?

Updated: Jul 01, 2020
  • Author: Emily Tommolino, MD; Chief Editor: BS Anand, MD  more...
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Answer

Appropriate antibiotic therapy and supportive care should be given to patients presenting with cholangitis. Patients who present at a late stage, after the development of advanced cirrhosis and portal hypertension, may not be good candidates for surgery because of the prohibitive morbidity and mortality associated with these comorbid conditions.

Note the following:

  • No medical therapy specifically targets the etiology of choledochal cysts, nor is any drug or any type of nonsurgical modality curative.

  • Patients who present with cholangitis should be treated with broad-spectrum antibiotic therapy directed against common biliary pathogens, such as Escherichia coli and Klebsiella species, in addition to other supportive measures, such as volume resuscitation.

  • Again, it must be emphasized that these means are supportive and that surgery is the only currently available definitive therapy.

Patients with choledochal cysts require lifelong follow-up because of an increased risk of cholangiocarcinoma and gallbladder carcinoma, even after complete excision of the cyst. [20]


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