Bile Duct Cysts in Adults

Abstract

In patients with BDC, particular attention must be given to the associated intrahepatic bile duct dilatations. We propose a modification of Todani's classification to distinguish cystic, segmental, and fusiform dilatations of the intrahepatic biliary tree in type IV cysts. In patients with segmental left intrahepatic cystic dilatations, combined left liver lobectomy and extrahepatic cyst excision is suggested to decrease late postsurgical biliary complications.

Clinicopathological Feature and Surgical Outcome of Choledochal Cyst in Different Age Groups: The Implication of Surgical Timing

“…Moreover, patients treated by means of the cystic drainage procedure carry an increased risk of malignant change. 19,23,25 We, therefore, in agreement with other reports, advocate complete cyst excision in these patients.…”

“…However, the incidence of malignant change ranges from 8% to 19% in the Asian literature, [22][23][24] with similar figures in some Western series. 25,26 Our policy of prompt surgical intervention and the younger patient population in our study may explain why cholangiocarcinoma was not encountered. Moreover, patients treated by means of the cystic drainage procedure carry an increased risk of malignant change.…”

Intrahepatic duct dilatation in type 4 choledochal malformation: pressure-related, postoperative resolution

“…Choledochal pressure was measured in 18 children, with a median pressure of 17 (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27) mm Hg. Median bile amylase was 3300 (500-58 000) IU/L.…”

“…What has been less clear is whether such dilatation persists after definitive surgery and its contribution to the long-term outcome of these patients. Certainly, complications such as stone formation and carcinomatous change seem to occur in those patients left with dilated intrahepatic biliary tracts [8][9][10][11][12].…”

Choledochal cysts: Age of presentation, symptoms, and late complications related to Todani's classification

“…However, the overall finding of 14% (non intrahepatic) cholangiocarcinoma is comparable with most recent series (Table 5). 2,13,[20][21][22][23][24][25][26][27] The concept of treatment of extrahepatic choledochal cysts has changed in the past 20 years because of a persistent high risk of malignancy after drainage procedures. 23,27 In addition, a high rate of benign complications, mainly anastomotic strictures, of internal drainage procedures has been reported.…”