Congenital bile duct cysts: classification, operative procedures,
and review of 37 cases including cancer arising from choledochal cyst
Takuji Todani, Yasuhiro Watanabe, Mitsuo Narusue, Katsusuke
Tabuchi, Kunio Okajima
Am J Surg 134: 263-269, 1977
Thirty-seven patients with congenital bile duct cysts,
including seventeen children and nine young adults, were encountered from
1960 to April 1976. Since the congenital bile duct cysts were observed in
any parts of the bile duct, from the liver to the duodenum, we prefer to
use the term "bile duct cyst," and we classify these cysts into
six types for surgical treatment, in contrast with Alonso-Lej's classification.
Based on experience with two patients in whom cancer arose from a choledochal
cyst, it seems that excision of the choledochal cyst is always the most
desirable operation for types Ia and Ib cysts in older children and young
adults. Partial resection of intrahepatic cysts should be added in some
cases of type IV-A cysts to achieve free drainage of the bile juice from
the intrahepatic cysts.
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