Differential Diagnoses

Workup

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. 2004 Jan. 23(1):93-4. [QxMD MEDLINE Link].
Sgro M, Rossetti S, Barozzino T, et al. Caroli's disease: prenatal diagnosis, postnatal outcome and genetic analysis. Ultrasound Obstet Gynecol. 2004 Jan. 23(1):73-6. [QxMD MEDLINE Link].
Yu ZL, Zhang LJ, Fu JZ, Li J, Zhang QY, Chen FL. Anomalous pancreaticobiliary junction: image analysis and treatment principles. Hepatobiliary Pancreat Dis Int. 2004 Feb. 3(1):136-9. [QxMD MEDLINE Link].
Fitoz S, Erden A, Boruban S. Magnetic resonance cholangiopancreatography of biliary system abnormalities in children. Clin Imaging. 2007 Mar-Apr. 31(2):93-101. [QxMD MEDLINE Link].
Ulas M, Polat E, Karaman K, et al. Management of choledochal cysts in adults: a retrospective analysis of 23 patients. Hepatogastroenterology. 2012 Jun. 59(116):1155-9. [QxMD MEDLINE Link].
Lee SE, Jang JY, Lee YJ, et al. Choledochal cyst and associated malignant tumors in adults: a multicenter survey in South Korea. Arch Surg. 2011 Oct. 146(10):1178-84. [QxMD MEDLINE Link].
Ahn SM, Jun JY, Lee WJ, et al. Laparoscopic total intracorporeal correction of choledochal cyst in pediatric population. J Laparoendosc Adv Surg Tech A. 2009 Oct. 19(5):683-6. [QxMD MEDLINE Link].
Chijiiwa K, Koga A. Surgical management and long-term follow-up of patients with choledochal cysts. Am J Surg. 1993 Feb. 165(2):238-42. [QxMD MEDLINE Link].
Douglas AH. Case of dilatation of the common bile duct. Monthly J M Sci (London). 1852. 14:97.
Todani T, Narusue M, Watanabe Y, Tabuchi K, Okajima K. Management of congenital choledochal cyst with intrahepatic involvement. Ann Surg. 1978 Mar. 187(3):272-80. [QxMD MEDLINE Link]. [Full Text].
Shah OJ, Shera AH, Zargar SA, et al. Choledochal cysts in children and adults with contrasting profiles: 11-year experience at a tertiary care center in Kashmir. World J Surg. 2009 Nov. 33(11):2403-11. [QxMD MEDLINE Link].
Singham J, Yoshida EM, Scudamore CH. Choledochal cysts: part 1 of 3: classification and pathogenesis. Can J Surg. 2009 Oct. 52(5):434-40. [QxMD MEDLINE Link]. [Full Text].
Miyano T, Yamataka A. Choledochal cysts. Curr Opin Pediatr. 1997 Jun. 9(3):283-8. [QxMD MEDLINE Link].
Todani T, Watanabe Y, Narusue M, Tabuchi K, Okajima K. Congenital bile duct cysts: classification, operative procedures, and review of thirty-seven cases including cancer arising from choledochal cyst. Am J Surg. 1977 Aug. 134(2):263-9. [QxMD MEDLINE Link].
Kilambi R, Singh AN, Madhusudhan KS, Das P, Pal S. Choledochal cyst of the proximal cystic duct: a taxonomical and therapeutic conundrum. Ann R Coll Surg Engl. 2018 Feb. 100(2):e34-e37. [QxMD MEDLINE Link]. [Full Text].
Ramachandran A, Srivastava DN, Gupta AK, Madhusudhan KS. The double trouble: a case of duplicated extrahepatic bile duct with choledochal cyst. Indian J Pediatr. 2019 Feb. 86(2):186-8. [QxMD MEDLINE Link].
Nuamah NM, Ibis C, Gok AFK, Ekiz F, Acunas B. Duplicated common bile duct: a recipe for biliary injury. Report of a new variant. J Surg Case Rep. 2017 Feb. 2017(2):rjx021. [QxMD MEDLINE Link]. [Full Text].
Banjade BM, Rajbhandari A, Koirala R, Shah T, Bhattachan CL. Type Va extrahepatic bile duct duplication: a case report. J Med Case Rep. 2019 Oct 28. 13(1):320. [QxMD MEDLINE Link]. [Full Text].
Nuamah NM, Ekiz F, Kartal G, Sunamak O, Sahiner IT. A new variant of double common bile duct associated with choledochal cyst. J Surg Case Rep. 2020 Jun. 2020(6):rjaa147. [QxMD MEDLINE Link]. [Full Text].
Madadi-Sanjani O, Wirth TC, Kuebler JF, Petersen C, Ure BM. Choledochal cyst and malignancy: a plea for lifelong follow-up. Eur J Pediatr Surg. 2019 Apr. 29(2):143-149. [QxMD MEDLINE Link].
Fieber SS, Nance FC. Choledochal cyst and neoplasm: a comprehensive review of 106 cases and presentation of two original cases. Am Surg. 1997 Nov. 63(11):982-7. [QxMD MEDLINE Link].
Wu GS, Zou SQ, Luo XW, Wu JH, Liu ZR. Proliferative activity of bile from congenital choledochal cyst patients. World J Gastroenterol. 2003 Jan. 9(1):184-7. [QxMD MEDLINE Link]. [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. 2004 Jun. 39(6):804-7; discussion 804-7. [QxMD MEDLINE Link].
Tang J, Zhang D, Liu W, Zeng JX, Yu JK, Gao Y. Differentiation between cystic biliary atresia and choledochal cyst: A retrospective analysis. J Paediatr Child Health. 2018 Apr. 54(4):383-9. [QxMD MEDLINE Link].
Jensen KK, Sohaey R. Antenatal sonographic diagnosis of choledochal cyst: Case report and imaging review. J Clin Ultrasound. 2015 Nov. 43(9):581-3. [QxMD MEDLINE Link].
Oduyebo I, Law JK, Zaheer A, Weiss MJ, Wolfgang C, Lennon AM. Choledochal or pancreatic cyst? Role of endoscopic ultrasound as an adjunct for diagnosis: a case series. Surg Endosc. 2015 Sep. 29(9):2832-6. [QxMD MEDLINE Link].
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. 2003 Nov-Dec. 28(6):847-52. [QxMD MEDLINE Link].
Senthilnathan P, Patel ND, Nair AS, Nalankilli VP, Vijay A, Palanivelu C. Laparoscopic management of choledochal cyst-technical modifications and outcome analysis. World J Surg. 2015 Oct. 39(10):2550-6. [QxMD MEDLINE Link].
Aly MYF, Mori Y, Miyasaka Y, et al. Laparoscopic surgery for congenital biliary dilatation: a single-institution experience. Surg Today. 2018 Jan. 48(1):44-50. [QxMD MEDLINE Link].
Nag HH, Sisodia K, Sheetal P, Govind H, Chandra S. Laparoscopic excision of the choledochal cyst in adult patients: An experience. J Minim Access Surg. 2017 Oct-Dec. 13 (4):261-4. [QxMD MEDLINE Link]. [Full Text].
Martinez-Ordaz JL, Morales-Camacho MY, Centellas-Hinojosa S, Roman-Ramirez E, Romero-Hernandez T, de la Fuente-Lira M. [Choledochal cyst during pregnancy. Report of 3 cases and a literature review] [Spanish, English]. Cir Cir. 2016 Mar-Apr. 84(2):144-53. [QxMD MEDLINE Link]. [Full Text].
Diao M, Li L, Cheng W. Recurrence of biliary tract obstructions after primary laparoscopic hepaticojejunostomy in children with choledochal cysts. Surg Endosc. 2016 Sep. 30(9):3910-5. [QxMD MEDLINE Link].
Chang J, Walsh RM, El-Hayek K. Hybrid laparoscopic-robotic management of type IVa choledochal cyst in the setting of prior Roux-en-Y gastric bypass: video case report and review of the literature. Surg Endosc. 2015 Jun. 29(6):1648-54. [QxMD MEDLINE Link].
Jordan PH Jr, Goss JA Jr, Rosenberg WR, Woods KL. Some considerations for management of choledochal cysts. Am J Surg. 2004 Jun. 187(6):790-5. [QxMD MEDLINE Link].
Edil BH, Olino K, Cameron JL. The current management of choledochal cysts. Adv Surg. 2009. 43:221-32. [QxMD MEDLINE Link].
Visser BC, Suh I, Way LW, Kang SM. Congenital choledochal cysts in adults. Arch Surg. 2004 Aug. 139(8):855-60; discussion 860-2. [QxMD MEDLINE Link].
Shimotakahara A, Yamataka A, Yanai T, et al. Roux-en-Y hepaticojejunostomy or hepaticoduodenostomy for biliary reconstruction during the surgical treatment of choledochal cyst: which is better?. Pediatr Surg Int. 2005 Jan. 21(1):5-7. [QxMD MEDLINE Link].
Mukhopadhyay B, Shukla RM, Mukhopadhyay M, et al. Choledochal cyst: A review of 79 cases and the role of hepaticodochoduodenostomy. J Indian Assoc Pediatr Surg. 2011 Apr. 16(2):54-7. [QxMD MEDLINE Link]. [Full Text].
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. 2006 Nov. 20(11):1762-5. [QxMD MEDLINE Link].
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. 2006 Apr. 16(2):179-83. [QxMD MEDLINE Link].
Lee SC, Kim HY, Jung SE, Park KW, Kim WK. Is excision of a choledochal cyst in the neonatal period necessary?. J Pediatr Surg. 2006 Dec. 41(12):1984-6. [QxMD MEDLINE Link].
Woon CY, Tan YM, Oei CL, Chung AY, Chow PK, Ooi LL. Adult choledochal cysts: an audit of surgical management. ANZ J Surg. 2006 Nov. 76(11):981-6. [QxMD MEDLINE Link].
Hernandez Bartolome MA, Fuerte Ruiz S, Manzanedo Romero I, et al. Biliary cystadenoma. World J Gastroenterol. 2009 Jul 28. 15(28):3573-5. [QxMD MEDLINE Link]. [Full Text].
Stringer MD, Dhawan A, Davenport M, Mieli-Vergani G, Mowat AP, Howard ER. Choledochal cysts: lessons from a 20 year experience. Arch Dis Child. 1995 Dec. 73(6):528-31. [QxMD MEDLINE Link].
Gadelhak N, Shehta A, Hamed H. Diagnosis and management of choledochal cyst: 20 years of single center experience. World J Gastroenterol. 2014 Jun 14. 20(22):7061-6. [QxMD MEDLINE Link]. [Full Text].
Qiao G, Li L, Li S, et al. Laparoscopic cyst excision and Roux-Y hepaticojejunostomy for children with choledochal cysts in China: a multicenter study. Surg Endosc. 2015 Jan. 29(1):140-4. [QxMD MEDLINE Link].

Media Gallery

Operative specimen of a type I choledochal cyst.
Type I choledochal cyst.
Type II choledochal cyst.
Type III choledochal cyst (choledochocele).
Type IV choledochal cyst (extrahepatic and intrahepatic disease).
Type V choledochal cyst (intrahepatic, Caroli disease).
Nuclear medicine scan of a choledochal cyst.
Nuclear medicine scan of a choledochal cyst.
Computed tomography (CT) scan of a choledochal cyst demonstrating intrahepatic extension involving the main left hepatic duct.
Computed tomography (CT) scan of a choledochal cyst involving the common hepatic duct.
Computed tomography (CT) scan demonstrating a large choledochal cyst and the adjacent gall bladder.
Computed tomography (CT) scan of a large, saccular type I choledochal cyst.
Diagnostic ultrasonogram demonstrating a type I choledochal cyst in a 4-month-old child presenting with hyperbilirubinemia and transaminase elevations.
Intraoperative cholangiogram of a type I choledochal cyst.
Intraoperative image of a Roux-en-Y hepaticojejunostomy to restore biliary-enteric continuity following resection of a choledochal cyst.

of 15

Author

Emily Tommolino, MD Chief Resident, Department of Internal Medicine, Providence Hospital

Emily Tommolino, MD is a member of the following medical societies: American College of Physicians

Disclosure: Nothing to disclose.

Coauthor(s)

Michael H Piper, MD Clinical Assistant Professor, Department of Internal Medicine, Division of Gastroenterology, Wayne State University School of Medicine; Consulting Staff, Digestive Health Associates, PLC

Michael H Piper, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Gastroenterology, American College of Physicians, Michigan State Medical Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

BS Anand, MD Professor, Department of Internal Medicine, Division of Gastroenterology, Baylor College of Medicine

BS Anand, MD is a member of the following medical societies: American Association for the Study of Liver Diseases, American College of Gastroenterology, American Gastroenterological Association, American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Additional Contributors

Michael AJ Sawyer, MD Consulting Staff, Department of Surgery, Comanche County Memorial Hospital; Medical Director, Lawton Bariatrics

Michael AJ Sawyer, MD is a member of the following medical societies: American Society for Metabolic and Bariatric Surgery, Society for Surgery of the Alimentary Tract, Society of Laparoendoscopic Surgeons, American College of Surgeons, Society of American Gastrointestinal and Endoscopic Surgeons

Disclosure: Nothing to disclose.

Acknowledgements

Mounzer Al Al Samman, MD Assistant Professor, Department of Internal Medicine, Division of Gastroenterology, Texas Tech University School of Medicine

Mounzer Al Al Samman, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, and American Gastroenterological Association

Disclosure: Nothing to disclose.

Thomas F Murphy, MD Chief of Abdominal Imaging Section, Department of Radiology, Tripler Army Medical Center

Disclosure: Nothing to disclose.

Tarak H Patel, MD Consulting Surgeon, Department of Surgery, Reynolds Army Medical Center, Fort Sill

Disclosure: Nothing to disclose.