Skip to main content
SpringerLink
Log in

Choledochal cyst disease: A review

  • Topics
  • Published:
Journal of Hepato-Biliary-Pancreatic Surgery

Abstract

The authors present a review of the classification, etiology, presentation, treatment and long-term outcome of children and adults with choledochal cyst disease. Unlike children, adults often present with acute biliary tract symptoms or pancreatitis. The treatment of choice remains extrahepatic cyst excision and biliary bypass. This treatment has excellent long-term results that minimize the development of malignancy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Komi N, Tamura T, Miyoshi Y, Kunitomo K, Udaha H, Takehara H. Nationwide survey of casess of choledochal cysts (1984) Analysis of coexistent anomalies, complications and surgical treatment in 645 cases. Surg Gastroenterol 3:69–73

    Google Scholar 

  2. Kepczyk KT, Angueira CE, Kudakia SC, Miller G, Melenson G (1995) Choledochal cyst mimicking a pancreatic pseudocyst. J Clin Gastroenterol 20(2):139–141

    CAS  PubMed  Google Scholar 

  3. Lipsett PA, Pitt HA, Colombani PM, Boitnott JK, Cameron JL (1994) Choledochal cyst disease: A changing pattern of presentation. Ann Surg 220:644–652

    CAS  PubMed  Google Scholar 

  4. Stain S, Guthrie CR, Yellin AE, Donovan AJ (1994) Choledochal cyst disease in the adult Ann Surgery 222:128–133

    Google Scholar 

  5. Vater A, Ezler CS (1723) Dissertatio, de scirrhis viserum occasione sections viri typanite defunte. Wittenburgae, 4 Pamphlers 881:22

    Google Scholar 

  6. Douglas AH (1852) Case of dilatation of common bile duct. Monthly J Med Sci (London) 14:97–101

    Google Scholar 

  7. McWhorter GL (1924) Congenital cystic dilatation of the common bile duct. Ann Surg 8:604–626

    Google Scholar 

  8. Alonso-Lej F, Rever WB Jr, Pessagno DJ (1959) Congenital choledochal cysts, with a report of 2, and an analysis of 94 cases. Surg Gynecol Obstet 108:1–30

    CAS  Google Scholar 

  9. Todani T, Watanabe Y, Narusue M, Tabuchi K Okajimi K, (1977) Congenital bile duct cysts. Classification, operative procedures, and review of 37 cases including cancer arising from choledochal cyst. AM J Surg 134:263–269

    Article  CAS  PubMed  Google Scholar 

  10. Caroli J, Soupalt R, Kossakowski J, Kossakowski J (1958) La dilatation polykstique congenitale des voico biliares intraheptiques; essai de classification. Sem Hop Paris, 34:488–495.

    CAS  PubMed  Google Scholar 

  11. Deziel D Rossi RL, Munson L, Braasch JW, Silverman ML (1986) Management of bile duct cysts in adults. Arch Surg 121:410–415

    CAS  PubMed  Google Scholar 

  12. Joseph VT (1990) Surgical techniques and long-term treatment results in the treatment of choledochal cysts. J Ped Surg 25:782–787

    CAS  Google Scholar 

  13. Flanagan DP (1975) Biliary cysts. Ann Surg 182:635–643

    Google Scholar 

  14. Lopez RR, Pinson CW, Campbell JR, Harrison M, Katon RM (1991) Variation in management based on type of choledochal cyst. Am J Surg 161:612–615

    Article  CAS  PubMed  Google Scholar 

  15. Okada A, Nakamura T, Higaki J, Okumura K, Kamata S, Oguchi Y (1990) Congenital dilation of the bile duct in 100 instances and its relationship with anomalous junction. Surg Gynecol Ob stet 171:291–298

    CAS  Google Scholar 

  16. Ohta H, Yamaguchi Y, Yamakawa O, Watanabe H, Satomura Y, Motoo Y, Okai T, Terada T, Sawabu N (1993) Biliary papillomatosis with the point mutation of K-ras gene arising in congenital choledochal cyst. Gastroenterology 105:1209–1212

    Google Scholar 

  17. Babbitt DP (1969) Congenital choledochal cysts. New etiological concepts on anomalous relationships of the common bile duct and pancreatic bulb. Ann Radiol 12:231–240

    CAS  PubMed  Google Scholar 

  18. Iwai N, Yanagihara J, Tokiwa K, Shimotaki E, Nakamura K (1992) Congenital choledochal dilatation with emphasis on pathophysiology of the biliary tract. Ann Surg 215:27–30

    CAS  PubMed  Google Scholar 

  19. Wong KC, Lister J (1991) Human fetal development of the hepato-pancreatic duct junction — a possible explanation of congenital dilatation of the biliary tract. J Pediatr Surg 16:139–145

    Google Scholar 

  20. Tanaka M, Ikeda S, Kawakami K (1982) The presence of a positive pressure gradient from pancreatic duct to choledochal cyst demonstrated by duodenoscopic microtransducer manometry: Clue to pancreaticobiliary reflux. Endoscopy 14:45

    CAS  PubMed  Google Scholar 

  21. Tanaka T (1995) Pathogenesis of choledochal cyst. Am J Gastroenterol 90:685

    CAS  PubMed  Google Scholar 

  22. Spitz L (1977) Experimental production of cystic dilatation of the common bile duct in lambs. J Pediatr Surg 12:39

    CAS  PubMed  Google Scholar 

  23. Ohkawa H, Sawaguchi S, Maie M (1988) Experimental analysis of the ill effect of anomalous pancreaticobiliary ductal union. J Pediatr Surg 17:7

    Google Scholar 

  24. Kusunoki M, Saitoh N, Yamamura T, Fujita S, Takahashi T, Utsunomiga J (1988) Choledochal cysts oligioganglionosis in the narrow portion of the choledochus. Arch Surg 123:984–986

    CAS  PubMed  Google Scholar 

  25. Tan KC, Howard ER (1988) Choledochal cyst: A 14-year surgical experience with 36 patients. Br J Surg 75:892–895

    CAS  PubMed  Google Scholar 

  26. Okada A, Higaki J, Nakamura T, Fukui Y, Kamata S (1995) Pancreatitis associated with choledochal cyst and other anomalies in childhood. Br J Surg 82:829–832

    CAS  PubMed  Google Scholar 

  27. Componovo E, Buck JL, Drane WE (1989) Scintigraphic features of choledochal cyst. J Nucl Med 30:622–628

    Google Scholar 

  28. Chesterman JT (1944) Choledochous cyst complicating pregnancy and the puerperium. J Obstet Gynaecol Br Emp 51:512

    Google Scholar 

  29. Yamashiro Y, Sato M, Hoshino A (1982) Spontaneous perforation of a choledochal cyst. Eur J Pediatr 138:193

    Article  CAS  PubMed  Google Scholar 

  30. Yamaguchi M (1980) Congenital choledochal cyst. Analysis of 1433 patients in the Japanese literature. Am J Surg 140:653–657

    Article  CAS  PubMed  Google Scholar 

  31. Chijiiwa K, Koga A (1993) Surgical management and long-term follow-up of patients with choledochal cysts. Am J Surg 165:238–242

    CAS  PubMed  Google Scholar 

  32. Irwin ST, Morison JE (1944) Congenital cyst of the common bileduct containing stones and undergoing cancerous change. Br J. Surg 32:319

    Google Scholar 

  33. Voyles CR, Smadja C, Shands WC, Blumgart LH (1983) Carcinoma in choledochal cysts. Age-related incidence. Arch Surg 118:986–988

    CAS  PubMed  Google Scholar 

  34. Todani T, Tabuchi K, Watanabe Y, Kobuyashi T (1979) Cancinoma arising in the wall of congenital bile duct cysts. Cancer 44:1134–1141

    CAS  PubMed  Google Scholar 

  35. Todani T, Watanabe Y, Toki A, Urushihara N (1987) Carcinoma related to choledochal cysts with internal drainage operation. Surg Gynecol Obstet 164:61–64

    CAS  PubMed  Google Scholar 

  36. Reveille RM, Van Stiegmann G, Everson G (1990) Increased secondary bile acids in a choledochal cyst. Possible role in biliary metaplasia and carcinoma. Gastroenterology 99:525–527

    CAS  PubMed  Google Scholar 

  37. O'Neil JA, Templeton JM Jr, Schnaufer L, Bishop HC, Ziegler MM Ross A III (1987) Recent experience with choledochal cyst. Ann Surg 205:533–540

    Google Scholar 

  38. Schmid C, Meyer HJ, Ringe B, Scheumann GFW, Pichlmayr R (1993) Cystic enlargement of extrahepatic bile ducts. Surgery 114:65–70

    CAS  PubMed  Google Scholar 

  39. Cósentino CM, Luck SR, Roffensperger JG, Reynolds M (1992) Choledochal duct cyst: Resection with physiologic resection. Surgery 112:740–748

    PubMed  Google Scholar 

  40. Rattner DW, Schapiro RH, Warshaw AL (1983) Abnormalities of the pancreatic and biliary ducts in adult patients with choledochal cysts. Arch Surg 118:1068–1073

    CAS  PubMed  Google Scholar 

  41. Lilly JR (1978) Total excision of choledochal cysts. Surg Gynecol Obst 146:254–256

    CAS  Google Scholar 

  42. Venu RP, Geenen JE, Hogan WJ, Dodds WJ, Wilson SW, Stewart ET, Soergel KH (1984) Role of endoscopic retrograde cholangiopancreatography in the diagnosis and treatment of choledochocele. Gastroenterology 87:1144–1149

    CAS  PubMed  Google Scholar 

  43. Shemesh E, Czerniak A, Klein E, Avigad I (1988) The role of endoscopic retrograde cholangiopancreatography in the diagnosis and treatment of adult choledochal cyst. Surg Gynecol Obst 167:423–426

    CAS  Google Scholar 

  44. Martin RF, Biber BP, Bosco JJ, Howell DA (1992) Symptomatic choledochoceles in adults. Endoscopic retrograde cholangiopancreatography recognition and management. Arch Surg 127:536–539

    CAS  PubMed  Google Scholar 

  45. Todani T, Naruse M, Wantanabe Y, Okajima K (1978) Management of congenital choledochal cyst with intrahepatic involvement. Ann Surg 187:272–280

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, The Johns Hopkins Hospital, 600 North Wolfe Street, 21287-4605, Baltimore, MD, USA

    Pamela A. Lipsett & John L. Cameron

Authors
  1. Pamela A. Lipsett
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. John L. Cameron
    View author publications

    You can also search for this author in PubMed Google Scholar

About this article

Cite this article

Lipsett, P.A., Cameron, J.L. Choledochal cyst disease: A review. J Hep Bil Pancr Surg 3, 389–395 (1996). https://doi.org/10.1007/BF02349782

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02349782

Key words

Search

Navigation