Adult type I choledochal cyst resection

J Gastrointest Surg. 2009 Feb;13(2):363-7. doi: 10.1007/s11605-008-0521-z. Epub 2008 Apr 30.

Abstract

Type I choledochal cysts are characterized by fusiform dilatation of the common bile duct, commonly associated with an anomalous pancreatobiliary duct junction. Most are diagnosed in childhood, but the diagnosis may be delayed until adulthood. All type I choledochal cysts should be resected because of the risk of malignant degeneration. The steps for resecting a type I choledochal cyst are described. Through a right subcostal incision, the cyst is exposed and transected distally as it narrows within the pancreatic parenchyma. A total transmural excision of the extrahepatic biliary tree is performed. A retrocolic Roux-en-Y hepaticojejunostomy restores biliary-enteric continuity. Thirty-day mortality is low and long-term outcomes are excellent.

Publication types

  • Review

MeSH terms

  • Adult
  • Anastomosis, Roux-en-Y
  • Choledochal Cyst / diagnosis
  • Choledochal Cyst / surgery*
  • Common Bile Duct / surgery*
  • Dissection
  • Humans
  • Jejunostomy