Further Outpatient Care
- Patients need lifelong follow-up because of the increased risk of cholangiocarcinoma, even after complete excision of the cyst.
Complications
- Patients undergoing excision of a choledochal cyst are subject to the usual complications associated with surgery, including hemorrhage, wound infection, bowel obstruction, and thrombotic complications.
- Postoperatively, patients are at risk of developing pancreatitis and ascending cholangitis.
- Late postoperative complications include development of intrahepatic bile duct stones and cholangiocarcinoma.
- Adult patients with long-standing subclinical ductal inflammation and biliary stasis may develop one or more of the following complications: hepatic abscesses, cirrhosis, portal hypertension, recurrent pancreatitis, and cholelithiasis.
Prognosis
- The prognosis after excision of a choledochal cyst is usually excellent (see Further Outpatient Care).
Patient Education
- For excellent patient education resources, visit eMedicine's Liver, Gallbladder, and Pancreas Center and Esophagus, Stomach, and Intestine Center. Also, see eMedicine's patient education articles Gallstones, Pancreatitis, Cirrhosis, and Abdominal Pain in Adults.
Douglas AH. Case of dilatation of the common bile duct. Monthly J M Sci (London). 1852;14:97.
Shah OJ, Shera AH, Zargar SA, Shah P, Robbani I, Dhar S, et al. Choledochal cysts in children and adults with contrasting profiles: 11-year experience at a tertiary care center in Kashmir. World J Surg. Nov 2009;33(11):2403-11. [Medline].
Singham J, Yoshida EM, Scudamore CH. Choledochal cysts: part 1 of 3: classification and pathogenesis. Can J Surg. Oct 2009;52(5):434-40. [Medline]. [Full Text].
Miyano T, Yamataka A. Choledochal cysts. Curr Opin Pediatr. Jun 1997;9(3):283-8. [Medline].
Wu GS, Zou SQ, Luo XW, Wu JH, Liu ZR. Proliferative activity of bile from congenital choledochal cyst patients. World J Gastroenterol. Jan 2003;9(1):184-7. [Medline].
Chen CP, Cheng SJ, Chang TY, Yeh LF, Lin YH, Wang W. Prenatal diagnosis of choledochal cyst using ultrasound and magnetic resonance imaging. Ultrasound Obstet Gynecol. Jan 2004;23(1):93-4. [Medline].
Sgro M, Rossetti S, Barozzino T, Toi A, Langer J, Harris PC, et al. Caroli's disease: prenatal diagnosis, postnatal outcome and genetic analysis. Ultrasound Obstet Gynecol. Jan 2004;23(1):73-6. [Medline].
Yu ZL, Zhang LJ, Fu JZ, Li J, Zhang QY, Chen FL. Anomalous pancreaticobiliary junction: image analysis and treatment principles. Hepatobiliary Pancreat Dis Int. Feb 2004;3(1):136-9. [Medline].
Fitoz S, Erden A, Boruban S. Magnetic resonance cholangiopancreatography of biliary system abnormalities in children. Clin Imaging. Mar-Apr 2007;31(2):93-101. [Medline].
Nagi B, Kochhar R, Bhasin D, Singh K. Endoscopic retrograde cholangiopancreatography in the evaluation of anomalous junction of the pancreaticobiliary duct and related disorders. Abdom Imaging. Nov-Dec 2003;28(6):847-52. [Medline].
Ulas M, Polat E, Karaman K, Dalgic T, Ercan M, Ozer I, et al. Management of Choledochal Cysts in Adults: A Retrospective Analysis of 23 Patients. Hepatogastroenterology. Nov 2 2011;59(115-116):[Medline].
Lee SE, Jang JY, Lee YJ, Choi DW, Lee WJ, Cho BH, et al. Choledochal cyst and associated malignant tumors in adults: a multicenter survey in South Korea. Arch Surg. Oct 2011;146(10):1178-84. [Medline].
Jordan PH Jr, Goss JA Jr, Rosenberg WR, Woods KL. Some considerations for management of choledochal cysts. Am J Surg. Jun 2004;187(6):790-5. [Medline].
Edil BH, Olino K, Cameron JL. The current management of choledochal cysts. Adv Surg. 2009;43:221-32. [Medline].
Visser BC, Suh I, Way LW, Kang SM. Congenital choledochal cysts in adults. Arch Surg. Aug 2004;139(8):855-60; discussion 860-2. [Medline].
Shimotakahara A, Yamataka A, Yanai T, Kobayashi H, Okazaki T, Lane GJ, et al. Roux-en-Y hepaticojejunostomy or hepaticoduodenostomy for biliary reconstruction during the surgical treatment of choledochal cyst: which is better?. Pediatr Surg Int. Jan 2005;5-7.:21(1). [Medline].
Mukhopadhyay B, Shukla RM, Mukhopadhyay M, Mandal KC, Mukherjee PP, Roy D, et al. Choledochal cyst: A review of 79 cases and the role of hepaticodochoduodenostomy. J Indian Assoc Pediatr Surg. Apr 2011;16(2):54-7. [Medline]. [Full Text].
Lee H, Hirose S, Bratton B, Farmer D. Initial experience with complex laparoscopic biliary surgery in children: biliary atresia and choledochal cyst. J Pediatr Surg. Jun 2004;39(6):804-7; discussion 804-7. [Medline].
Jang JY, Kim SW, Han HS, Yoon YS, Han SS, Park YH. Totally laparoscopic management of choledochal cysts using a four-hole method. Surg Endosc. Nov 2006;20(11):1762-5.
Woo R, Le D, Albanese CT, Kim SS. Robot-assisted laparoscopic resection of a type I choledochal cyst in a child. J Laparoendosc Adv Surg Tech A. Apr 2006;16(2):179-83. [Medline].
Lee SC, Kim HY, Jung SE, Park KW, Kim WK. Is excision of a choledochal cyst in the neonatal period necessary?. J Pediatr Surg. Dec 2006;41(12):1984-6. [Medline].
Woon CY, Tan YM, Oei CL, Chung AY, Chow PK, Ooi LL. Adult choledochal cysts: an audit of surgical management. ANZ J Surg. Nov 2006;76(11):981-6. [Medline].
Ahn SM, Jun JY, Lee WJ, Oh JT, Han SJ, Choi SH, et al. Laparoscopic total intracorporeal correction of choledochal cyst in pediatric population. J Laparoendosc Adv Surg Tech A. Oct 2009;19(5):683-6. [Medline].
Chijiiwa K, Koga A. Surgical management and long-term follow-up of patients with choledochal cysts. Am J Surg. Feb 1993;165(2):238-42. [Medline].
Dundas SE, Robinson-Bridgewater LA, Duncan ND. Antenatal diagnosis of a choledochal cyst. Case management and literature review. West Indian Med J. Sep 2002;51(3):184-7. [Medline].
Fieber SS, Nance FC. Choledochal cyst and neoplasm: a comprehensive review of 106 cases and presentation of two original cases. Am Surg. Nov 1997;63(11):982-7. [Medline].
Gallivan EK, Crombleholme TM, D'Alton ME. Early prenatal diagnosis of choledochal cyst. Prenat Diagn. Oct 1996;16(10):934-7. [Medline].
Hernandez Bartolome MA, Fuerte Ruiz S, Manzanedo Romero I, Ramos Lojo B, Rodriguez Prieto I, Gimenez Alvira L, et al. Biliary cystadenoma. World J Gastroenterol. Jul 28 2009;15(28):3573-5. [Medline].
Hewitt PM, Krige JE, Bornman PC, Terblanche J. Choledochal cysts in adults. Br J Surg. Mar 1995;82(3):382-5. [Medline].
Ishibashi T, Kasahara K, Yasuda Y, Nagai H, Makino S, Kanazawa K. Malignant change in the biliary tract after excision of choledochal cyst. Br J Surg. Dec 1997;84(12):1687-91. [Medline].
Kubota H, Eckelman WC, Poulose KP, Reba RC. Technetium-99m-pyridoxylideneglutamate, a new agent for gallbladder imaging: comparison with 131I-rose bengal. J Nucl Med. Jan 1976;17(1):36-9. [Medline].
Lindberg CG, Hammarstrom LE, Holmin T, Lundstedt C. Cholangiographic appearance of bile-duct cysts. Abdom Imaging. Nov-Dec 1998;23(6):611-5. [Medline].
Rabie ME, Al-Humayed SM, Hosni MH, Katwah RA, Dewan M. Choledochocele: the disputed origin. Int Surg. Oct-Dec 2002;87(4):221-5. [Medline].
Rha SY, Stovroff MC, Glick PL, Allen JE, Ricketts RR. Choledochal cysts: a ten year experience. Am Surg. Jan 1996;62(1):30-4. [Medline].
Saing H, Han H, Chan KL, Lam W, Chan FL, Cheng W, et al. Early and late results of excision of choledochal cysts. J Pediatr Surg. Nov 1997;32(11):1563-6. [Medline].
Schultz RM. The potential role of cytokines in cancer therapy. Prog Drug Res. 1992;39:219-50. [Medline].
Stringer MD, Dhawan A, Davenport M, Mieli-Vergani G, Mowat AP, Howard ER. Choledochal cysts: lessons from a 20 year experience. Arch Dis Child. Dec 1995;73(6):528-31. [Medline].
Weyant MJ, Maluccio MA, Bertagnolli MM, Daly JM. Choledochal cysts in adults: a report of two cases and review of the literature. Am J Gastroenterol. Dec 1998;93(12):2580-3. [Medline].
Yamataka A, Ohshiro K, Okada Y, Hosoda Y, Fujiwara T, Kohno S, et al. Complications after cyst excision with hepaticoenterostomy for choledochal cysts and their surgical management in children versus adults. J Pediatr Surg. Jul 1997;32(7):1097-102. [Medline].

