Skip to Main Content

+

  • • Type I cysts (fusiform dilation of common bile duct [CBD]) account for 85-90%

    • Type II (true diverticula of CBD) 1-2% of cases

    • Type III (choledochocele—dilation of distal/intramural portion of CBD) < 2% of cases

    • Type IV (multiple cysts involving intrahepatic and extrahepatic ducts) as high as 15% of cases in some series

    • Type V (cystic malformation of intrahepatic ducts) rare

    • 3-5% incidence of carcinoma

++

Epidemiology

+

  • • Onset of symptoms usually in infancy or childhood

++

Symptoms and Signs

+

  • • Jaundice

    • Fever

    • Pain

    • Palpable right upper quadrant mass

    • Hepatomegaly

    • Bleeding varices

    • Asymptomatic

++

Laboratory Findings

+

  • • Hyperbilirubinemia

    • Elevated alkaline phosphatase

    • Leukocytosis

    • Elevated amylase and lipase

++

Imaging Findings

+

  • • US showing characteristic cystic dilation of biliary tree corresponding to type as well as proximal dilation in presence of obstruction

    • ERCP or magnetic resonance cholangiopancreatography (MRCP) showing cystic dilation corresponding to type and proximal obstruction in presence of obstruction

+

  • • Type of choledochal cyst

+

  • • History and physical exam

    • Liver function tests

    • CBC

    • Amylase and lipase

    • Abdominal US

    • ERCP or MRCP (adults)

    • HIDA scan or MRCP (children)

++

Surgery

+

  • • Cyst excision and biliary reconstruction (types I-III)

    • Types IV and V individualized and may require partial hepatectomy if unilobar involvement

++

Treatment Monitoring

+

  • • Surveillance for carcinoma since patients still at increased risk for remainder of biliary tree

++

Complications

+

  • • Biliary stricture or leak

    • Cholangitis

++

References

Vercruysse R, Van den Bossche MR. Choledochal cyst in adults. Acta Chir Belg. 1998;98:220.  [PubMed: 9830548]
Watanatittan S, Niramis R: Choledochal cyst: review of 74 pediatric cases. J Med Assoc Thai 1998;81:586.  [PubMed: 9737111]

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessSurgery Full Site: One-Year Subscription

Connect to the full suite of AccessSurgery content and resources including more than 160 instructional videos, 16,000+ high-quality images, interactive board review, 20+ textbooks, and more.

$995 USD
Buy Now

Pay Per View: Timed Access to all of AccessSurgery

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.