Intraoperative strategies for difficult surgical excision of adult congenital biliary dilatation        PENG Bao-gang, TANG Di. Department of Hepatobiliary Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
Corresponding author: PENG Bao-gang, E-mail:pengbaogang@medmail.com.cn
Abstract    The general treatments for adult congenital biliary dilatation (CBD) usually include resection of cystic dilated bile ducts and liver lesions, removing of bile stones, and cholangioenterostomy. However, some patients may have complex history and manifestations. With the progress of the disease, many complicated changes of the liver, biliary system, pancreas and portal vein system, such as calculus of bile duct, carcinoma of bile duct, pancreatitis and portal hypertension may occur. Besides, part of patients might have the experience of several times of surgery. The above factors confront surgical treatment of the disease with a lot of difficulties and challenges. For difficult surgical excision situations, individuated surgical procedures should be undertaken according to the characteristic of each patient. In general, it should maximize the excision of lesions and preservation of normal tissues and avoid serious postoperative complications.