[Cysts of the choledochus. Report of a case]

Cysts of the common bile duct, (also known as common bile coeles, or as common bile cysts) are quite rare. Those of the ampulla of Vater are a curious phenomena. Cysts of the extrahepatic part of the common bile duct can be quite large, excentrically located, and produce a triad of symptoms: pain, tumor and jaundice. These symptoms are intermittent, however, due to the periodic emptying of the cysts' contents into the duodenum. Cysts of the ampulla of Vater are those which occur in the intraduodenal part of the bile duct, and almost always found projecting into the lumen of the duodenum--imitating a tumor as it was in our case. Preoperative diagnosis of these cysts is extremely difficult, especially if the cyst is situated on the ampullar part of the common bile duct, and they are usually discovered during the operation. Possible compression of the ampulla of Vater, and the pancreatic duct can result in recidivating pancreatitis. The operative approach is dependent on the size of the cyst, and its location. The best is the complete removal of the cyst, and a correction of bile flow.